Antidepressants withdrawal symptoms from

The reason for this warning is that abrupt cessation of SSRIs produces withdrawal symptoms in about 20 per cent of patients. Symptoms of withdrawal from antidepressant medication include gastrointestinal disturbances (abdominal cramping and pain, diarrhoea, nausea and vomiting), flu-like symptoms, headaches, sleep disturbances, dizziness, blurred vision, numbness, electric-shock sensations, twitches and tremors. Abrupt withdrawal can also produce symptoms of depression and anxiety, which can occur within hours of the first missed dose of the drug.11 Withdrawal symptoms are sometimes mistaken for a relapse, leading patients to resume antidepressant medication and to conclude that they need it in order to remain free of depression. Technically, this is not considered addiction , but it does seem awfully close. 

Detoxification, as mentioned in Chapter 2, may involve the use of certain medications to prevent severe discomfort or even possible medical side effects related to withdrawal symptoms. These medicines can range from tranquilizers (often benzodiazepines) and antidepressants to anticonvulsives and antihypertensives, and the medical protocol for detox will depend on the drug or drugs being abused, the client s vital signs and other symptoms, and the known risk for certain withdrawal symptoms associated with the drugs being used. The duration... 

Tricyclic antidepressants also have a documented syndrome associated with withdrawal from medications (Petti and Law, 1981). This syndrome can mimic appendicitis or the flu, and can include such symptoms as nausea and vomiting, headache, lethargy, and abdominal pain. If a child on TCAs presents with withdrawal symptoms, questions of compliance must be addressed. 

Opioids (especially methadone and heroin) are the most common cause of serious neonatal drug withdrawal symptoms. Other dmgs for which a withdrawal syndrome has been reported include phencyclidine (POP), cocaine, amphetamines, tricyclic antidepressants, phenothiazines, benzodiazepines, barbiturates, ethanol, clonidine, diphenhydramine, lithium, meprobamate, and theophylline. A careful dmg history from the mother should include illicit drugs, alcohol, and prescription and over-the-counter medications, and whether she is breast-feeding. 

Fetotoxicity There have been reports of neonatal withdrawal symptoms with SSRIs, but httle is known of this phenomenon with other antidepressants. When seven mother-child pairs exposed to venlafaxine from the second trimester were studied p "], five of the neonates had a withdrawal syndrome, including tachypnea and respiratory distress the changes corresponded to falling plasma venlafaxine concentrations. The neonate exposed to the highest maternal dose of venlafaxine (300 mg/day) had the most severe and most persistent signs. 

The older tricyclic antidepressants and monoamine oxidase inhibitors also cause withdrawal mania and a variety of other adverse withdrawal effects, including cognitive and emotional disturbances and psychosis. Many of them have strong anticholinergic effects and therefore produce severe anticholinergic rebound on withdrawal, including cardiovascular and gastrointestinal symptoms. I have seen patients who have taken tricyclics for many years and then been unable to withdraw from them. 

Psychiatric symptoms have been prospectively examined in 104 patients with chronic hepatitis C, of whom 84 received interferon alfa-2b 15 MU/week and 20 were not treated (338). The incidence of clinically relevant scores for depression, anxiety, or anger/hostility increased from 23% of patients before interferon alfa to 58% of patients during treatment, and returned to 30% and 19% of patients 4 weeks and 6 months after withdrawal respectively. In contrast, there were no significant changes in the reference group. There were also significantly higher scores in the 40 patients who took concomitant ribavirin. Six patients successfully received antidepressant therapy, but withdrawal because of untreatable psychiatric symptoms was needed in 8.3% of patients, i.e. about half of the patients who had interferon-induced major depressive disorders. 

In addition, withdrawal from certain medications, such as baclofen, clonidine, corticosteroids, or tricyclic antidepressants, may cause manic symptoms. 

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