Selective serotonin reuptake inhibitors discontinuation

Rosenbaum, J.F., Fava, M., Hoog, S.L., Acroft, R.C., and Krebs, WB. (1998) Selective serotonin reuptake inhibitor discontinuation syndrome a randomized clinical trial. Biol Psychiatry 44 77-87. 

Markowitz JS, DeVane CL, Liston HL, Montgomery SA. An assessment of selective serotonin reuptake inhibitor discontinuation symptoms with citalopram. Int Clin Psychopharmacol 2000 15(6) 329-33. 

Goethe JW, Woolley SB, Cardoni AA, et al. Selective serotonin reuptake inhibitor discontinuation side effects and other factors that influence medication adherence. J Clin Psychopharmacol 2007 27(5) 451-8. 

In a similar study, however, reduced Glx levels were observed in the anterior cingulum of depressed patients. The level of Glx was found to increase upon effective ECT." The effects of selective serotonin reuptake inhibitor discontinuation syndrome have been investigated in patients with unipolar major depression who had been stabilised on paroxetine or fluoxetine. H NMR spectroscopic imaging of the rostral anterior cingulate was carried out 3 days after substitution of medication with a selective serotonin reuptake inhibitor or a placebo. The ratio of Cho/tCr was deceased in patients who met the criteria of selective serotonin reuptake inhibitor discontinuation syndrome compared to asymptomatic subjects." ... 

The first-line therapeutic options for PMDD include the selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, fluvoxamine, sertraline, paroxetine, and citalopram. These agents can be given either continuously or only during the luteal phase of the menstrual cycle, i.e., initiated at the time of ovulation and discontinued on the first day of menses. 

Haddad P (1998) The SSRI discontinuation syndrome. J Psychopharmacol 12 305-313 Healy D (2003) Lines of evidence on the risks of suicide with selective serotonin reuptake inhibitors. Psychother Psychosom 72 71-79... 

Anderson DN, Wilkinson AM, Abou-Saleh MT, et al Recovery from depression after electroconvulsive therapy is accompanied by evidence of increased tetra-hydrobiopterin-dependent hydroxylation. Acta Psychiatr Scand 90 10-13, 1994 Anderson IM, Cowen PJ Effect of pindolol on endocrine and temperature responses to buspirone in healthy volunteers. Psychopharmacology 106 428-432, 1992 Anderson IM, Tomenson BM Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants a meta-analysis. BMJ 310 1433-1438, 1995... 

Song F, Freemantle N, Sheldon TA Selective serotonin reuptake inhibitors meta-analysis of efficacy and acceptabihty. BMJ 306(6879) 683-687, 1993 Song L, Jope R Chronic lithium treatment impairs phosphatidylinositol hydrolysis in membranes from rat brain regions. J Neurochem 58 2200-2206, 1992 Souza EG, Mander AJ, Goodwin GM The efficacy of lithium in prophylaxis of unipolar depression evidenced from its discontinuation. Br J Psychiatry 157 718-722, 1990... 

The discovery of the antidepressant effect of medications was coincidental to their use for other disorders. Initial work published in 1952 reported that iproniazid (originally used for the treatment of tuberculosis) could elevate mood. Although the use of iproniazid was discontinued due to toxicity, many other additional medications have been tested and approved for the treatment of depression. These include monoamine oxidase inhibitors, tricyclics, selective serotonin reuptake inhibitors, and a heterogeneous class of atypical drugs. 

Reinblatt and Riddle (2006) stated, Selective serotonin reuptake inhibitor (SSRI)-induced apathy is characterized by a lack of motivation that is not a result of sedation or symptoms of depression. In a review of 43 participants in a fluvoxamine pediatric research project, the authors identified two (5%) cases of apathy, one in a 9-year-old and the other in a 16-year-old, neither of whom was depressed. They found that similarities to existing reports included Lack of insight, delayed onset, dose dependency, and reversibility with SSRI dose reduction or discontinuation. ... 

Discontinuing selective serotonin reuptake inhibitors (SSRIs) may induce a syndrome wherein the main neuropsychiatric symptoms are dizziness, shock-like sensations, anxiety, irritability, agitation, and insomnia. These symptoms usually develop 1 to 7 days after abrupt or gradual discontinuation. Antidepressant discontinuation may also induce mania, mainly reported with tricyclics and monoamine oxidase inhibitors but also observed with SSRIs. 

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