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Antidepressivt utsättningssyndrom

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Definition:
Typiska symtom i anslutning till hastigt avslutad behandling med antidepressiva läkemedel.
Förekomst:
Oklar incidens och prevalens.
Symtom:
Symtomen kan vara förkylningsliknande, sömnproblem, illamående, yrsel, sensoriska störningar och känsla av "elektriska stötar" i huvudet.
Kliniska fynd:
Inga typiska kliniska fynd vi utsättningssyndrom till följd av uppehåll/avslutad behandling med SSRI/SNRI. Parkinsonism och balansproblem kan förekomma vid uppehåll/avslutad behandling med tricykliska antidepressiva.
Utsättningssyndrom efter användning av MAOI-preparat kan innefatta mer allvarliga tecken som aggressivitet, agitation, katatoni, allvarliga kognitiva störningar, myoklonus eller psykotiska symtom.
Diagnostik:
Typisk anamnes med symtom inom tre dagar efter uppehåll eller minskning av dosen antidepressiva.
Behandling:
Ordna med en långsammare nedtrappning av det antidepressiva läkemedlet. Symtomen är vanligtvis lindriga och går över spontant inom en till två veckor. I sällsynta fall vid utsättningssyndrom efter användning av MAOI-preparat kan psykiatrisk vård krävas.
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  • Hans Ågren, professor emeritus och överläkare, Sektionen för psykiatri och neurokemi, Sahlgrenska akademin, Göteborgs universitet
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet