Selective serotonin reuptake inhibitor discontinuation syndrome in children: Six case reports

Abstract

Background: Antidepressant discontinuation syndrome refers to a cluster of symptoms that occur after abrupt dose reduction or discontinuation of antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are increasingly being used for the treatment of depression and other psychiatric disorders in children and adolescents, but published data on SSRI discontinuation syndrome in children are limited. Objective: This paper presents 6 case reports of SSRI discontinuation syndrome in children. Results: SSRI discontinuation syndrome was diagnosed in 6 patients (4 boys, 2 girls; mean age, 11.33 ± 1.75 years) according to established criteria. Three patients had been taking paroxetine, 2 fluvoxamine, and 1 sertraline for an average of 4.00 ± 1.67 months (range, 3–6 months) before abrupt discontinuation or dose reduction. Dizziness/lightheadedness/drowsiness, poor concentration, nausea, headache, and fatigue were the most frequent symptoms. As in previous studies in adults, the 6 patients experienced SSRI discontinuation symptoms 1 to 5 days (mean 2.92 ± 1.63 days) after SSRI discontinuation or dose reduction. In all patients, symptoms resolved on reinitiation of treatment with the same SSRI or a different one. Conclusions: The case reports presented in this article suggest that SSRI discontinuation syndrome can and does occur in children when treatment is stopped or the SSRI dose is reduced abruptly, and is quite similar to that reported in adults. Placebo-controlled prospective studies are needed in children to further assess the prevalence and clinical presentation of SSRI discontinuation syndrome and to develop management strategies for this condition.