Barkho Ashour, Elhusein Bushra, Gajebasia Niman
Department of Pharmacy, London Health Sciences Centre, ON, Canada.
Department of Psychiatry, London Health Sciences Centre, ON, Canada.
SAGE Open Med Case Rep. 2025 May 24;13:2050313X251342973. doi: 10.1177/2050313X251342973. eCollection 2025.
Antidepressant discontinuation syndrome is commonly observed among patients who abruptly discontinue or reduce the dosage of an antidepressant that has been administered for at least 6 weeks. Common manifestations may include flu-like symptoms, insomnia, nausea, impaired balance, sensory disturbances, headache, irritability, anxiety, and hyperarousal. These symptoms are typically mild, persist for 1-2 weeks, and resolve upon resumption of the medication. The probability of developing this syndrome increases with the prescribed pharmacological agent's prolonged treatment duration and shorter half-life. Before prescribing antidepressants, it is imperative to inform patients about the potential complications associated with the sudden discontinuation of the medication. Understanding this phenomenon can help prevent future incidents and reduce nonadherence risk. The majority of antidepressants possess the potential to induce antidepressant discontinuation syndrome. This case report presents a unique instance of discontinuation syndrome in a 50-year-old female patient with major depressive disorder who had been effectively managed on desvenlafaxine for several years. After initiating domperidone for chemotherapy-induced nausea, she experienced "brain zaps" and other symptoms consistent with antidepressant discontinuation syndrome. Upon cessation of domperidone, her symptoms rapidly resolved. This report examines potential interactions between domperidone and desvenlafaxine, emphasizing the necessity for clinicians to be cognizant of possible drug interactions that may precipitate discontinuation symptoms.
抗抑郁药停药综合征常见于突然停用或减少已服用至少6周的抗抑郁药剂量的患者中。常见表现可能包括流感样症状、失眠、恶心、平衡障碍、感觉障碍、头痛、易怒、焦虑和易激惹。这些症状通常较轻,持续1 - 2周,恢复用药后症状会缓解。发生这种综合征的可能性会随着所开药物治疗时间延长和半衰期缩短而增加。在开抗抑郁药之前,必须告知患者突然停药可能产生的并发症。了解这种现象有助于预防未来事件并降低不依从风险。大多数抗抑郁药都有可能诱发抗抑郁药停药综合征。本病例报告呈现了一名50岁患有重度抑郁症的女性患者出现停药综合征的独特案例,该患者多年患者多年来一直服用去甲文拉法辛有效控制病情。在开始使用多潘立酮治疗化疗引起的恶心后,她出现了“脑鸣”和其他与抗抑郁药停药综合征相符的症状。停用多潘立酮后,她的症状迅速缓解。本报告探讨了多潘立酮与去甲文拉法辛之间可能的相互作用,强调临床医生必须认识到可能引发停药症状的药物相互作用。