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抗抑郁药停药后耳鸣发作的病例报告及文献综述

A case report of onset of tinnitus following discontinuation of antidepressant and a review of the literature.

作者信息

Clewes Jane

机构信息

North Staffordshire Combined Healthcare NHS Trust, Central Therapies Mental Health, Harplands Hospital, Stoke-on-Trent, Staffordshire, United Kingdom.

出版信息

Prim Care Companion CNS Disord. 2012;14(1). doi: 10.4088/PCC.11br01218. Epub 2012 Feb 16.

Abstract

This case report describes a 46-year-old woman with long-standing episodic severe depression (ICD-10 code F33) who discontinued venlafaxine over a 4-week taper after taking the antidepressant for 8 years. Severe discontinuation syndrome was experienced. Panic and relapse of depression occurred 2 months after achieving discontinuation, and the development of tinnitus took place concurrently to the discontinuation. The experience of the tinnitus as a side effect of discontinuation is different from cases reported in the literature in which the tinnitus was experienced when the antidepressant was started and ceased when the antidepressant was stopped. Here, the patient experienced the tinnitus as a discontinuation symptom, and it persisted even after the antidepressant was reintroduced. A review of the literature on antidepressant discontinuation syndrome is also provided.

摘要

本病例报告描述了一名46岁患有长期发作性重度抑郁症(ICD - 10编码F33)的女性,她在服用抗抑郁药8年后,经过4周的逐渐减量过程停用了文拉法辛。她经历了严重的停药综合征。停药2个月后出现惊恐发作和抑郁症复发,耳鸣在停药时同时出现。作为停药副作用出现耳鸣的情况与文献报道的病例不同,文献中的病例是在开始服用抗抑郁药时出现耳鸣,并在停药时消失。在此病例中,患者将耳鸣体验为停药症状,即使重新服用抗抑郁药后耳鸣仍持续存在。本文还提供了关于抗抑郁药停药综合征的文献综述。

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本文引用的文献

2
Abrupt withdrawal of antidepressant treatment.抗抑郁治疗的突然停药。
Am J Psychiatry. 2010 Aug;167(8):886-8. doi: 10.1176/appi.ajp.2010.10050783.
4
Illness risk following rapid versus gradual discontinuation of antidepressants.抗抑郁药快速停药与逐渐停药后的疾病风险。
Am J Psychiatry. 2010 Aug;167(8):934-41. doi: 10.1176/appi.ajp.2010.09060880. Epub 2010 May 17.
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Persistent tinnitus induced by tricyclic antidepressants.
J Psychopharmacol. 2010 Aug;24(8):1273-5. doi: 10.1177/0269881109106929. Epub 2009 Oct 13.
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Venlafaxine-associated tinnitus.
Am J Health Syst Pharm. 2009 Sep 15;66(18):1606, 1608. doi: 10.2146/ajhp090309.
9
Pathophysiology of tinnitus.耳鸣的病理生理学
Prog Brain Res. 2007;166:19-35. doi: 10.1016/S0079-6123(07)66002-6.

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