Schatzberg A F, Haddad P, Kaplan E M, Lejoyeux M, Rosenbaum J F, Young A H, Zajecka J
Department of Psychiatry, Stanford University School of Medicine, California 94305, USA.
J Clin Psychiatry. 1997;58 Suppl 7:23-7.
Although the number of documented serotonin reuptake inhibitor (SRI) discontinuation reactions is increasing, to date no systematic studies have been completed; therefore the mechanism of action for these reactions is not clearly understood. However, several hypotheses have been proposed. Researchers have postulated that discontinuation events result from a sudden decrease in the availability of synaptic serotonin in the face of down-regulated serotonin receptors. In addition, other neurotransmitters, such as dopamine, norepinephrine, or gamma-aminobutyric acid (GABA), may also be involved, although little research in this area has been published. Individual patient sensitivity, i.e., genetics or cognitive mindset, may also be a factor in SRI discontinuation phenomena. Finally, experts have hypothesized that since some symptoms associated with paroxetine withdrawal are similar to those of tricyclic antidepressant discontinuation, they may be caused by cholinergic rebound.
尽管有记录的血清素再摄取抑制剂（SRI）停药反应的数量在增加，但迄今为止尚未完成系统研究；因此，这些反应的作用机制尚不清楚。然而，已经提出了几种假说。研究人员推测，停药事件是由于血清素受体下调时突触血清素可用性突然下降所致。此外，其他神经递质，如多巴胺、去甲肾上腺素或γ-氨基丁酸（GABA），也可能参与其中，尽管该领域发表的研究很少。个体患者的敏感性，即遗传因素或认知心态，也可能是SRI停药现象的一个因素。最后，专家们推测，由于与帕罗西汀戒断相关的一些症状与三环类抗抑郁药停药的症状相似，它们可能是由胆碱能反弹引起的。
