The abrupt discontinuation of fluvoxamine in patients with panic disorder.
BACKGROUND
We evaluated patients abruptly withdrawn from fluvoxamine, a serotonin selective reuptake inhibitor, for evidence of a discontinuation syndrome.


METHODS
In an open-label study, 14 subjects were abruptly withdrawn from fluvoxamine after treatment lasting 8 months (7 months for 1 patient). Psychological, somatic, and perceptual symptoms were assessed at Day 5, Day 10, and Day 14 postdiscontinuation. Anxiety and depression were assessed using clinician and self-rated scales.


RESULTS
Twelve (86%) of 14 subjects developed new symptoms. The most frequent symptoms reported were dizziness/incoordination, headaches, nausea, and irritability. Symptoms peaked on Day 5 postdiscontinuation. Only 1 subject had a recurrence of panic, but another developed anxiety and depression; both were remedicated.


CONCLUSIONS
Abrupt fluvoxamine discontinuation is associated with a characteristic syndrome in many patients.
Black
D W
DW
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
Wesner
R
R
Gabel
J
J
D000328:Adult; D001008:Anxiety Disorders / Q000139:chemically induced / Q000175:diagnosis; D003866:Depressive Disorder / Q000139:chemically induced / Q000175:diagnosis; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D016666:Fluvoxamine / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000139:chemically induced / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013577:Syndrome
D016666:Fluvoxamine