Shock‐Like Sensations During Venlafaxine Withdrawal

Reeves, Roy R.; Mack, James E.; Beddingfield, John J

doi:10.1592/phco.23.5.678.32198

Cited by 24 publications

(14 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Venlafaxine was generally reintroduced to address these symptoms. Other management methods included fluoxetine [48,51], chlorpromazine [53], ondansetron [56], sertraline [57], a low dosage of lorazepam [58], a combination of lorazepam and valproate [60], and duloxetine [62,66]. Duloxetine Three case reports of duloxetine withdrawal reactions were retrieved [67][68][69].…”

Section: Withdrawal Symptoms In Case Reportsmentioning

confidence: 99%

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Fava

Benasi

Lucente

et al. 2018

Psychother Psychosom

152

146

View full text Add to dashboard Cite

Background: Serotonin-noradrenaline reuptake inhibitors (SNRI) are widely used in medical practice. Their discontinuation has been associated with a wide range of symptoms. The aim of this paper is to identify the occurrence, frequency, and features of withdrawal symptoms after SNRI discontinuation. Methods: PRISMA guidelines were followed to conduct a systematic review. Electronic databases included PubMed, the Cochrane Library, Web of Science, and MEDLINE from the inception of each database to June 2017. Titles, abstracts, and topics were searched using a combination of the following terms: “duloxetine” OR “venlafaxine” OR “desvenlafaxine” OR “milnacipran” OR “levomilnacipran” OR “SNRI” OR “second generation antidepressant” OR “serotonin norepinephrine reuptake inhibitor” AND “discontinuation” OR “withdrawal” OR “rebound.” Only published trials in the English language were included. Results: Sixty-one reports met the criteria for inclusion. There were 22 double-blind randomized controlled trials, 6 studies where patients were treated in an open fashion and then randomized to a double-blind controlled phase, 8 open trials, 1 prospective naturalistic study, 1 retrospective study, and 23 case reports. Withdrawal symptoms occurred after discontinuation of any type of SNRI. The prevalence of withdrawal symptoms varied across reports and appeared to be higher with venlafaxine. Symptoms typically ensued within a few days from discontinuation and lasted a few weeks, also with gradual tapering. Late onset and/or a longer persistence of disturbances occurred as well. Conclusions: Clinicians need to add SNRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with other types of psychotropic drugs. The results of this study challenge the use of SNRI as first-line treatment for mood and anxiety disorders.

show abstract

Section: Withdrawal Symptoms In Case Reportsmentioning

confidence: 99%

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Fava

Benasi

Lucente

et al. 2018

Psychother Psychosom

152

146

View full text Add to dashboard Cite

show abstract

“…The most frequent symptoms are nausea, dizziness, fatigue, anxiety, headache, insomnia, and paresthesia. Shock-like sensations have also been described after abrupt withdrawal of SSRIs and venlafaxine but not with the more recently marketed agent duloxetine (2,3). Here, we describe the case of a major depressed woman treated with duloxetine who experienced shock-like sensations after discontinuation of duloxetine.…”

mentioning

confidence: 87%

Shock-Like Sensations Associated with Duloxetine Discontinuation

Pitchot¹,

Ansseau²

2008

Annals of Clinical Psychiatry

View full text Add to dashboard Cite

Abrupt interruption of antidepressive medications has been associated with a discontinuation syndrome including somatic and psychological symptoms. Discontinuation-emergent adverse events (DEAEs) have been reported nearly with all classes of antidepressants but mainly with selective serotonin reuptake inhibitors (SSRIs) and the norepinephrine/serotonin reuptake inhibitor venlafaxine, and to a lesser extent with duloxetine (1-3). The most frequent symptoms are nausea, dizziness, fatigue, anxiety, headache, insomnia, and paresthesia. Shock-like sensations have also been described after abrupt withdrawal of SSRIs and venlafaxine but not with the more recently marketed agent duloxetine (2, 3). Here, we describe the case of a major depressed woman treated with duloxetine who experienced shock-like sensations after discontinuation of duloxetine.Mrs A. is a 29-year-old woman who received 60 mg of duloxetine for a single major depressive episode. She did not have any other axis I or axis II diagnoses according to DSM-IV criteria. She achieved remission after 3 weeks of treatment. About 3 months later, she missed one dose of duloxetine, and 36 hours later she experienced nausea, dizziness, and strange sensations in the brain described as electric shocks appearing very frequently in a "stroboscopic manner." These brain sensations were considered as very disturbing. They lasted 8 hours and disappeared about 3 hours after the intake of duloxetine 60 mg. Treatment with duloxetine was maintained 3 months more and then gradually tapered to 15 mg before a complete interruption. About 2 days after duloxetine discontinuation, the patient experienced the same symptomatology as before with "electric shocks inside the head," nausea, and dizziness. This symptomatology persisted for 3 days and finally resolved after initiation of a treatment with fluoxetine, which was continued for more than 3 months. The maintenance of fluoxetine was requested by the patient who expressed a real fear of having these shocklike reactions again. The patient never experienced this kind of sensation before the treatment of her mood episode.The discontinuation syndrome associated with the interruption of duloxetine treatment induced very important discomfort. The symptom profile appears quite similar to that reported with SSRIs and venlafaxine. In a recent study, a pooled analysis of 6 short-term trials assessing the impact of an abrupt interruption of duloxetine, DEAEs were reported by 44.3% of the patients in the duloxetine group compared to 22.9% in the placebo group (3). The mechanism underlying the discontinuation syndrome is not fully understood, but the pharmacokinetic half-life of the medication seems to be an important factor. Antidepressants with a short half-life tend to be associated with a significant rate of DEAEs and a higher severity level (1). As the half-life of duloxetine is short (12 hours), a gradual reduction of the dose should be recommended to the clinician in a very clear way. REFERENCES1. Michelson D, Fava M, Amsterdam J, Apter J, ...

show abstract

“…Discontinuation symptoms are commonly described in patients taking venlafaxine (Pinzani et al, 2000;Baboolal, 2004). Shock-like sensation has been described with the discontinuation of venlafaxine (Reeves et al, 2003) and more often with the discontinuation of selective serotonin reuptake inhibitors (SSRIs) (Black et al, 2000). This case differs from others because the patient was taking a sub-therapeutic dose and the duration of the discontinuation symptoms was longer.…”

Section: Venlafaxine Discontinuation Symptoms On Prolonged Low Dosementioning

confidence: 99%

Venlafaxine discontinuation symptoms on prolonged low dose

Dechene¹

2005

Psychiatr. bull.

View full text Add to dashboard Cite

Shock‐Like Sensations During Venlafaxine Withdrawal

Cited by 24 publications

References 19 publications

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Shock-Like Sensations Associated with Duloxetine Discontinuation

Venlafaxine discontinuation symptoms on prolonged low dose

Contact Info

Product

Resources

About