Haddad P
Prestwich Hospital, Manchester, United Kingdom.
J Clin Psychiatry. 1997;58 Suppl 7:17-21; discussion 22.
Data on discontinuation phenomena associated with serotonin selective reuptake inhibitors (SSRIs) are derived primarily from (1) published case reports, (2) data bases of adverse drug reactions that have been spontaneously reported to national monitoring bureaus, and (3) clinical studies of drug discontinuation. Some of the symptoms seen on SSRI discontinuation, such as nausea, lethargy, insomnia, and headache, are similar to those reported with tricyclic discontinuation. However, SSRI discontinuation is also associated with novel symptom clusters, including problems with balance, sensory abnormalities, and possibly aggressive and impulsive behavior. Although generally mild and short-lived, discontinuation symptoms can be severe and chronic and have a major impact on the patient's lifestyle. The incidence of discontinuation symptoms varies widely among the different SSRIs; the highest rate is seen with paroxetine. The variation in incidence might be explained by the different pharmacokinetic and pharmacodynamic profiles of the SSRIs.
与5-羟色胺选择性再摄取抑制剂（SSRI）相关的停药现象的数据主要来源于：（1）已发表的病例报告；（2）自发上报给国家监测机构的药物不良反应数据库；（3）药物停药的临床研究。一些在停用SSRI时出现的症状，如恶心、嗜睡、失眠和头痛，与停用三环类药物时报告的症状相似。然而，停用SSRI还与一些新的症状群有关，包括平衡问题、感觉异常，以及可能出现的攻击和冲动行为。尽管停药症状通常较轻且持续时间短，但也可能严重且呈慢性，对患者的生活方式产生重大影响。不同SSRI之间停药症状的发生率差异很大；帕罗西汀的发生率最高。发生率的差异可能由SSRI不同的药代动力学和药效学特征来解释。
