Selective serotonin reuptake inhibitor discontinuation syndrome: A review

Tamam, Lut; Özpoyraz, Nurgül

doi:10.1007/bf02850015

Cited by 60 publications

(37 citation statements)

References 24 publications

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“…Studies of SSRIs in patients with major psychiatric disorders, for example depression or obsessive compulsive disorder, suggest that SSRIs are potentially associated with certain safety risks, including neurocognitive AEs such as anxiety, hypomania, akathisia and changes in mood [Coupland et al 1996;Khan et al 2003;Tamam and Ozpoyraz, 2002;Zajecka et al 1997]. Systematic analysis of randomized, controlled studies suggested a small increase in the risk of suicidal ideation or suicide attempts in youth [Khan et al 2003] but not in adults [Khan et al 2003;Mann et al 2006].…”

Section: Neurocognitive Safetymentioning

confidence: 99%

Dapoxetine: a new option in the medical management of premature ejaculation

McMahon

2012

Therapeutic Advances in Urology

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Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological consequences. Pharmacotherapy of PE with off-label antidepressant selective serotonin reuptake inhibitors (SSRIs) is common, effective and safe. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill an unmet treatment need. The objective of this article is to review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. MEDLINE, Web of Science, PICA, EMBASE and the proceedings of major international and regional scientific meetings were searched for publications or abstracts published during the period 1993-2012 that used the word 'dapoxetine' in the title, abstract or keywords. This search was then manually cross referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase I, II and III studies, independent postmarketing and pharmacovigilance efficacy and safety studies and drug-interaction studies. Dapoxetine is a potent SSRI which is administered on demand 1-3 h prior to planned sexual contact. It is rapidly absorbed and eliminated, resulting in minimal accumulation, and has doseproportional pharmacokinetics which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in five industry-sponsored randomized, double-blind, placebo-controlled studies in 6081 men aged at least 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, Clinical Global Impression of Change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (all p <0.001). The most common treatment-related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg), dizziness (5.9% for 30 mg, 10.9% for 60 mg), and headache (5.6% for 30 mg, 8.8% for 60 mg), and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use. Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.

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Section: Neurocognitive Safetymentioning

confidence: 99%

Dapoxetine: a new option in the medical management of premature ejaculation

McMahon

2012

Therapeutic Advances in Urology

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“…If being discontinued, however, SSRIs should be tapered over a 2-week period to avoid SSRI discontinuation syndrome, including dizziness, vertigo, headache, nausea, and insomnia. 74 Of note, bupropion has been associated with minor increases in blood pressure, 73 so blood pressure monitoring is recommended.…”

Section: Pharmacotherapymentioning

confidence: 99%

Depression and Cardiovascular Disease

Whooley¹

2006

JAMA

219

163

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Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. CASE PRESENTATIONA 58-year-old man with a history of coronary heart disease (CHD), type 2 diabetes mellitus, hypertension, smoking, and alcohol dependence presented for routine medical care. He had initially sought medical attention for exertional angina 5 years previously, at which time he underwent exercise treadmill testing with thallium that was positive for reversible perfusion defects in the anterior, septal, and inferior walls. Subsequent coronary angiography revealed diffuse heavy calcifications in the left anterior descending artery with a moderate lesion prior to the first diagonal. Several major septal perforators had significant lesions at their origins. In the dominant right coronary artery, there were diffuse calcifications but no significant lesions. The left circumflex and large ramus intermedius were free of discrete lesions. Left ventricular function was normal.The patient underwent single-vessel (left internal mammary artery to left anterior descending artery) coronary artery bypass grafting (CABG) surgery. He was prescribed atenolol 100 mg/ d, lisinopril 40 mg/d, lovastatin 80 mg/d, aspirin 325 mg/d, metformin 850 mg 3 times a day, and glipizide 10 mg 2 times a day. Despite being nonadherent to his prescribed medications, he remained stable for 5 years, but then one day, while doing household chores, he suddenly developed chest pressure, shortness of breath, and diaphoresis that lasted 12 hours. On admission to the hospital his troponin I was elevated and peaked at 0.7 ng/mL (normal, <0.05 ng/mL), consistent with a myocardial infarction (MI). His electrocardiogram had not changed.

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“…Half lives and withdrawal rates of SSRIs are also important in occurrence of withdrawal symptoms. Withdrawal syndrome is more frequently reported especially in SSRIs with a shorter half life such as paroxetine and sertraline (14). Use of SSRIs leads to desensitization in serotonin receptors, resulting in a down-regulation in receptors.…”

Section: Discussionmentioning

confidence: 99%

Mania/hypomania associated with withdrawal of antidepressants

Guduk¹,

Erensoy²,

Ersumer³

2013

Dusunen Adam

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Mania/hypomania associated with withdrawal of antidepressants Although paradoxical mania/hypomania due to antidepressant withdrawal is rarely reported in the literature as case report, it is possible that it may be observed more commonly in the clinical settings. Paradoxical mania/hypomania is reported to be associated with tricyclic antidepressants as well as selective serotonin reuptake inhibitors and other antidepressants. Although paradoxical mania/hypomania due to sertraline and paroxetine withdrawal are reported individually, we will discuss a patient with paradoxical mania/ hypomania due to withdrawal of both antidepressants administered at two different time periods, since this is the only case reported so far.Key words: Antidepressant withdrawal, hypomania, mania, paroxetine, sertraline ÖZET Antidepresan kesilmesine bağlı mani/hipomani Antidepresan kesilmesi sonrası "paradoksal" mani/hipomani, literatürde az sayıda olgu bildirimi şeklinde yer almakla birlikte, klinikte daha sık karşılaşılıyor olması muhtemeldir. Sıklıkla trisiklik antidepresanlarla (TSA) bildirilmiş olup, selektif serotonin geri alım inhibitörleri (SSGİ) ve daha nadir olarak diğer antidepresanlarla da bildirilmiştir. Sertralin ve paroksetin kesilmesine bağlı bildirilmiş olgular olmakla birlikte, aynı hastada farklı dönemlerde hem sertralin hem de paroksetin kesilmesine bağlı gelişen manik dönem olarak literatürdeki bilinen tek örnek olması açısından ilginç olduğunu düşündüğümüz bir olgu tartışılmıştır.

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Selective serotonin reuptake inhibitor discontinuation syndrome: A review

Cited by 60 publications

References 24 publications

Dapoxetine: a new option in the medical management of premature ejaculation

Dapoxetine: a new option in the medical management of premature ejaculation

Depression and Cardiovascular Disease

Mania/hypomania associated with withdrawal of antidepressants

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