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'''SSRI Discontinuation Syndrome''' also known as SSRI Withdrawal Syndrome or SSRI Cessation Syndrome, is a condition that can occur following the interruption or discontinuation of regular [[SSRI]] or [[SNRI]] usage (as well as many other types of [[Central Nervous System]] drugs, such as [[tricyclic antidepressant]]s and [[MAOI]]s). The condition can begin between 24 hours to one week after discontinuation, depending on the [[half-life]] of the drug.
SSRIs are not addictive in the conventional medical use of the word (i.e. animals given free access to the drug do not actively seek it out and do not seek to increase the dose), but suddenly discontinuing their use is known to produce both somatic and psychological withdrawal symptoms, as described by researchers.<ref>{{cite journal | author = Tamam L, Ozpoyraz N | title = Selective serotonin reuptake inhibitor discontinuation syndrome: a review | journal = Adv Ther | volume = 19 | issue = 1 | pages = 17-26 | year = | id = PMID 12008858}}</ref> Compared to the withdrawal symptoms of such drugs as opiates, alcohol, or cocaine, these reactions are quite different and frequently less significant, although the prescribing labels acknowledge the possibility of "intolerable" discontinuation reactions and some patients are never able to completely withdraw from SSRI drugs
In Europe, SSRI manufacturers are not permitted to promote their products as "non-habit forming"; in the U.S., this statement is used to promote SSRIs: "SSRIs meet the World Health Organization definition of 'addictive'."{{Citation needed}}▼
▲In Europe, SSRI manufacturers are not permitted to promote their products as "non-habit forming"; in the U.S., this statement is used to promote SSRIs: "SSRIs meet the World Health Organization definition of 'addictive'."
==Symptoms==
A number of possible symptoms can characterize SSRI discontinuation syndrome. They can include:
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==Discontinuation of Venlafaxine==
Sudden discontinuation of [[venlafaxine]] has a high risk of causing potentially severe [[withdrawal]] symptoms.<ref name="AmJPsych1997-fava">{{cite journal | author = Fava M, Mulroy R, Alpert J, Nierenberg A, Rosenbaum J | title = Emergence of adverse events following discontinuation of treatment with extended-release venlafaxine | journal = Am J Psychiatry | volume = 154 | issue = 12 | pages = 1760-2 | year = 1997 | id = PMID 9396960}}</ref> The high risk of withdrawal symptoms may reflect venlafaxines short half-life.<ref name="DrugSaf2001-Haddad"/> Missing even a single dose can induce discontinuation effects in some patients.<ref name="ANZ JPsych1998-parker">{{cite journal | author = Parker G, Blennerhassett J | title = Withdrawal reactions associated with venlafaxine | journal = Aust N Z J Psychiatry | volume = 32 | issue = 2 | pages = 291-4 | year = 1998 | id = PMID 9588310}}</ref> Discontinuations have a tendency to be ''significantly stronger'' than the withdrawal effects of other antidepressants including the [[tricyclic antidepressants]],
Symptoms of discontinuation are similar to other antidepressants including irritability, restlessness, headache, nausea, fatigue, excessive sweating, [[dysphoria]], [[tremor]], [[Vertigo (medical)|vertigo]], irregularities in blood pressure, dizziness, visual and auditory hallucinations, feelings of abdominal distension, and [[paresthesia]]. Other non-specific mental symptoms may include impaired concentration, bizarre dreams, delirium, [[cataplexy]], [[Agitation (emotion)|agitation]], and worsening of depressive symptoms.<ref name="AmJPsych1997-fava"/><ref name="DrugSaf2001-Haddad"/><ref name="ANZ JPsych1998-parker"/><ref>{{cite journal | author = van Noorden M, Vergouwen A, Koerselman G | title = [Delirium during withdrawal of venlafaxine] | journal = Ned Tijdschr Geneeskd | volume = 146 | issue = 26 | pages = 1236-7 | year = 2002 | id = PMID 12132141}}</ref><ref>{{cite journal | author = Nissen C, Feige B, Nofzinger E, Riemann D, Berger M, Voderholzer U | title = Transient narcolepsy-cataplexy syndrome after discontinuation of the antidepressant venlafaxine | journal = J Sleep Res | volume = 14 | issue = 2 | pages = 207-8 | year = 2005 | id = PMID 15910521}}</ref><ref name="JClinPsy2004-Baboolal">{{cite journal | author = Baboolal N | title = Venlafaxine withdrawal syndrome: report of seven cases in Trinidad | journal = J Clin Psychopharmacol | volume = 24 | issue = 2 | pages = 229-31 | year = 2004 | id = PMID 15206672}}</ref><ref name="AmJPsych1997-agelink">{{cite journal | author = Agelink M, Zitzelsberger A, Klieser E | title = Withdrawal syndrome after discontinuation of venlafaxine | journal = Am J Psychiatry | volume = 154 | issue = 10 | pages = 1473-4 | year = 1997 | id = PMID 9326838}}</ref> One symptom may include a feeling of spinning, similar to drunken "bed spins"; patients may experience spinning in two different directions, often felt between the area of the head above the nose and below the nose. This feeling of spinning is associated with severe nausea and disorientation.
Studies by Wyeth-Ayerst and others have reported occasional cases of withdrawal symptoms ''severe enough to require permanent use''.{{citation needed}} In some of these cases, successful discontinuation was eventually achieved by the addition of [[fluoxetine]], which was later discontinued itself without difficulty.
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