Abrupt discontinuation of a tricyclic antidepressant can result in a variety of unpleasant symptoms for the patient. This was first described by Dilsaver et al.
Symptoms associated with tricyclic antidepressant discontinuation:
(1) anxiety, panic attacks or agitation
(2) anorexia, nausea, vomiting or other gastrointestinal distress
(3) general somatic distress including diaphoresis, chills, lethargy and/or headache
(4) sleep disturbances (excessive dreaming, insomnia)
(5) movement disorders (akathisia, parkinsonism)
(6) hypomania or behavioral activation (mania, delirium)
(7) cardiac arrhythmias
where:
• Akathisia involves motor restlessness that may include an inability to sit still.
The differential diagnosis would include continued activity of the underlying anxiety-depressive syndrome.
Purpose: To evaluate a patient recently treated with a tricyclic antidepressant for symptoms of the discontinuation syndrome.
Specialty: Psychiatry, Pharmacology, clinical
Objective: clinical diagnosis, including family history for genetics
ICD-10: F19.9, F31, F32, F33, F34, T43.0,