Alharmoodi Khaled, Kathirgamachelvam Janarth, Nafri Deena
Liaison Psychiatry, The Lakes Mental Health Hospital, Colchester, GBR.
Cureus. 2024 Jul 1;16(7):e63560. doi: 10.7759/cureus.63560. eCollection 2024 Jul.
This case report describes a 26-year-old female with a history of childhood depression who experienced severe gastrointestinal symptoms and significant weight loss following the discontinuation of venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI). After tapering off the medication, days after cessation, she developed early satiety, nausea, bloating, and vomiting, leading to severe malnutrition with a body mass index (BMI) of 14. Despite the onset of symptoms being within the typical duration for discontinuation syndrome, extensive medical evaluations revealed no physical cause for her symptoms. Psychological assessment showed no current depression or anxiety, and she denied any eating disorder behaviors, suggesting a prolonged discontinuation syndrome. Her symptoms improved with the initiation of mirtazapine. This case underscores the importance of careful management when discontinuing venlafaxine, highlighting the potential for prolonged and severe discontinuation symptoms.
本病例报告描述了一名26岁女性,有童年抑郁症病史,在停用5-羟色胺-去甲肾上腺素再摄取抑制剂(SNRI)文拉法辛后出现严重的胃肠道症状和显著体重减轻。在逐渐减药停药数天后,她出现早饱、恶心、腹胀和呕吐,导致严重营养不良,体重指数(BMI)为14。尽管症状出现时间在停药综合征的典型持续时间内,但广泛的医学评估未发现其症状的生理原因。心理评估显示目前没有抑郁或焦虑,且她否认有任何饮食失调行为,提示为持续性停药综合征。开始使用米氮平后她的症状有所改善。本病例强调了停用文拉法辛时谨慎管理的重要性,突出了出现持续性和严重停药症状的可能性。