Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne Melbourne, VIC, Australia.
Front Pharmacol. 2013 Apr 16;4:45. doi: 10.3389/fphar.2013.00045. eCollection 2013.
Besides demonstrated efficacy, selective serotonin reuptake inhibitors (SSRIs) hold other advantages over earlier antidepressants such as greater tolerability and a wider range of clinical applications. However, there is a growing body of clinical evidence which suggests that SSRIs could, in some cases, be associated with a withdrawal reaction upon cessation of regular use. In addition to sensory and gastrointestinal-related symptoms, the somatic symptoms of the SSRI discontinuation syndrome include dizziness, lethargy, and sleep disturbances. Psychological symptoms have also been documented, usually developing within 1-7 days following SSRI discontinuation. The characteristics of the discontinuation syndrome have been linked to the half-life of a given SSRI, with a greater number of reports emerging from paroxetine compared to other SSRIs. However, many aspects of the neurobiology of the SSRI discontinuation syndrome (or SSRI withdrawal syndrome) remain unresolved. Following a comprehensive overview of the clinical evidence, we will discuss the underlying pathophysiology of the SSRI discontinuation syndrome and comment on the use of animal models to better understand this condition.
除了已证实的疗效外,选择性 5-羟色胺再摄取抑制剂(SSRIs)相较于早期的抗抑郁药还具有其他优势,如更好的耐受性和更广泛的临床应用。然而,越来越多的临床证据表明,SSRIs 在某些情况下可能会在常规使用停止后出现戒断反应。除了与感觉和胃肠道相关的症状外,SSRIs 停药综合征的躯体症状还包括头晕、乏力和睡眠障碍。心理症状也有记录,通常在停止使用 SSRIs 后 1-7 天内出现。停药综合征的特征与特定 SSRIs 的半衰期有关,与其他 SSRIs 相比,报告更多的是帕罗西汀。然而,SSRIs 停药综合征(或 SSRIs 戒断综合征)的许多神经生物学方面仍未得到解决。在对临床证据进行全面概述后,我们将讨论 SSRIs 停药综合征的潜在病理生理学,并评论使用动物模型来更好地理解这种情况。