Shock-Like Sensations During Venlafaxine Withdrawal
Shock-Like Sensations During Venlafaxine Withdrawal
Electric shock-like sensations may occur after cessation of treatment with serotonin selective reuptake inhibitors but are reported in the literature only rarely with discontinuation of venlafaxine. Two patients experienced severe shock-like sensations during venlafaxine withdrawal. For both patients symptoms occurred with lowering of the dosage and persisted for 5 days after complete discontinuation of the drug. These sensations may represent significant alteration of neuronal activity in the central nervous system.
Venlafaxine is an antidepressant that inhibits uptake of both norepinephrine and serotonin. Based on a MEDLINE search from 1990-2002, venlafaxine withdrawal symptoms were described or noted in English-language publications in at least 43 patients. These include six individual case reports, descriptions of two cases, and a series of three cases. In addition, 13 such reactions occurred between 1996 and 1998 in Australia. Six of eight patients ending an 8-week clinical trial required a gradual dosage reduction because they were experiencing withdrawal and rebound symptoms. In a clinical trial of venlafaxine for obsessive-compulsive disorder, four of nine patients developed a withdrawal syndrome at the end of a 12-week course of treatment. Seven of nine subjects in a clinical trial with extended-release venlafaxine reported adverse events over 3 days after stopping the agent.
The most common symptoms of venlafaxine withdrawal are fatigue, irritability, dizziness, gastrointestinal distress, headache, and anxiety. Others are sweating, nightmares, vertigo, ataxia, cramps, emotional lability, arthralgia, and paresthesia. Although shock-like sensations have been described several times on discontinuing selective serotonin reuptake inhibitors (SSRIs) and were noted in initial clinical trials with venlafaxine, of the literature cited by MEDLINE, only a single case report described this adverse event with abrupt cessation of the agent.
Electric shock-like sensations may occur after cessation of treatment with serotonin selective reuptake inhibitors but are reported in the literature only rarely with discontinuation of venlafaxine. Two patients experienced severe shock-like sensations during venlafaxine withdrawal. For both patients symptoms occurred with lowering of the dosage and persisted for 5 days after complete discontinuation of the drug. These sensations may represent significant alteration of neuronal activity in the central nervous system.
Venlafaxine is an antidepressant that inhibits uptake of both norepinephrine and serotonin. Based on a MEDLINE search from 1990-2002, venlafaxine withdrawal symptoms were described or noted in English-language publications in at least 43 patients. These include six individual case reports, descriptions of two cases, and a series of three cases. In addition, 13 such reactions occurred between 1996 and 1998 in Australia. Six of eight patients ending an 8-week clinical trial required a gradual dosage reduction because they were experiencing withdrawal and rebound symptoms. In a clinical trial of venlafaxine for obsessive-compulsive disorder, four of nine patients developed a withdrawal syndrome at the end of a 12-week course of treatment. Seven of nine subjects in a clinical trial with extended-release venlafaxine reported adverse events over 3 days after stopping the agent.
The most common symptoms of venlafaxine withdrawal are fatigue, irritability, dizziness, gastrointestinal distress, headache, and anxiety. Others are sweating, nightmares, vertigo, ataxia, cramps, emotional lability, arthralgia, and paresthesia. Although shock-like sensations have been described several times on discontinuing selective serotonin reuptake inhibitors (SSRIs) and were noted in initial clinical trials with venlafaxine, of the literature cited by MEDLINE, only a single case report described this adverse event with abrupt cessation of the agent.
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