DATE      CITATION           DRUG                     REPORT                                      

1996	Coupland et al.	Paroxetine Fluvoxamine Sertraline Fluoxetine	This paper reports the results of a retrospective chart review of patients treated with SSRIs (also clomipramine) in an outpatient clinic. In the 158 patients who were supervised during gradual tapering and discontinuation of SSRIs, the most common symptoms were dizziness, lethargy, paresthesia, nausea, vivid dreams, irritability and lowered mood.  The most common symptom, "dizziness" was variously described as having a "swimming, spaced-out, drunken or buzzing quality and was markedly exacerbated by movement". The next most common symptom was "paresthesia" which was described as "burning, tingling or like electric shocks". Symptoms occurred much more frequently in patients treated with shorter half-life SSRIs (FVX, PRX) than in patients on SRN or FLX. Symptoms persisted for up to three weeks (mean 11.8 days).
1998	Benazzi	Fluvoxamine	Patient was a 33-year old woman being treated for recurrent major depression and panic disorder, with fluvoxamine 200mg/day and clonazepam 2mg/day. After six months, fluvoxamine was slowly withdrawn. At 50mg/day, she began to suffer typical SSRI symptoms, but these worsened and were accompanied by severe depression and new, severe symptoms of aggressiveness, irritability and fatigue alternating with intense agitation. Patient had previously experienced typical symptoms after paroxetine  withdrawal "which lasted many weeks but disappeared within a few days after fluvoxamine was introduced".
1998	Macdonald	Paroxetine(17), sertraline (4), fluoxetine (3), fluvoxamine(2).	This short report summarises the 26 reports of withdrawal reactions reported to the Canadian Adverse Drug Reaction Monitoring Programme, for the four available SSRIs.  In 15 cases, drug was restarted; in 10 cases symptoms abated. Of particular interest: three of the 26 cases (drug not specified) resulted in hospitalisation or prolonged hospitalisation;  and in one case, "electric shock-like" symptoms (paresthesia) persisted for four years after discontinuation of paroxetine.
1999	Mahendran & Chan	Fluoxetine, fluvoxamine	Interviews with nine Asian patients, treated in Singapore, who had spontaneously and abruptly discontinued treatment with an SSRI suggested that seven had experienced withdrawal symptoms - three of the four patients taking fluoxetine and all four patients on fluvoxamine
2001	Hirose	Fluvoxamine	Case report - believed to be the first published report of SSRI withdrawal in Japan - in which abrupt drug discontinuation produced marked symptoms of restlessness. Symptoms soon disappeared when patient was put back on drug.
2001	Silvestri et al	Fluvoxamine Paroxetine	Investigation of sleep disruption induced by SSRI use in 14 healthy volunteers, in a 31-day protocol (7 days pre-drug, 19 days on drug and 5 days of acute withdrawal). Paroxetine disrupted sleep more than fluvoxamine and paroxetine-induced sleep disturbance persisted into the withdrawal phase
2002	Diler & Avci	Paroxetine, Fluvoxamine Sertraline	Six case reports describing withdrawal symptoms (following abrupt and gradual discontinuation) in children (mean age 11.33 +/- 1.75 years) taking paroxetine (3 cases), fluvoxamine (2 cases) and sertraline. The withdrawal syndrome in children is described as similar to that experienced by adults; supportive strategies are discussed.

Fluvoxamine (Faverin/Luvox): "Symptoms, including headache, nausea, dizziness and anxiety, have rarely been reported after abrupt discontinuation of Faverin".

	Contents page
	References
	Table: all reports of SSRI withdrawal