Smith Paul F, Darlington Cynthia L
Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, Dunedin, New Zealand.
Acta Otolaryngol. 2010 Sep;130(9):981-3. doi: 10.3109/00016481003602082.
Dizziness is the most commonly reported symptom of abrupt discontinuation from the selective serotonin reuptake inhibitor (SSRI) category of antidepressants. The reported dizziness is exacerbated by even slight head movement, and therefore is likely to be vestibular in origin. The SSRIs most implicated are those with short half-lives and which are most selective for serotonin (as opposed to noradrenaline), e.g. paroxetine and sertraline. Since the vestibular nucleus complex (VNC) has an abundance of serotonin receptors, the abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it. Here we suggest that the abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo.
头晕是突然停用选择性5-羟色胺再摄取抑制剂（SSRI）类抗抑郁药后最常报告的症状。即使是轻微的头部运动也会加剧所报告的头晕，因此其根源可能是前庭性的。最常涉及的SSRI是那些半衰期短且对5-羟色胺（与去甲肾上腺素相对）具有最高选择性的药物，例如帕罗西汀和舍曲林。由于前庭神经核复合体（VNC）有大量的5-羟色胺受体，突然停用SSRI可能会对其中的神经元电生理活动产生重大影响。在此我们认为，突然停用SSRI可能会导致VNC中5-羟色胺突然减少，这将双侧破坏VNC神经元的功能，导致头晕但无眩晕。
