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Abstract: Venlafaxine is a dual antidepressant very popular in the treatment of major depression and anxiety disorders. There are many side effects of venlafaxine data but very little about the effect of abrupt discontinuation of treatment.
We present a case of 34 years male patient diagnosed Major Depression Disorder who developed delirium after abrupt stopping treatment with venlafaxine XR. The patient was treated with venlafaxine XR 150mg/day over 3 months for depressive symptoms that were added delusions of death and marked anxiety. 12 hours after abrupt discontinuation of venlafaxine XR he began to be agitated, disorientated, with visual hallucinations, tachycardia and sweating. After 72 hours of treatment the patient's condition has improved significantly with remission of symptoms of delirium. The venlafaxine withdrawal syndrome diagnosis was established after evaluation of all parameters, including brain CT and laboratory blood tests.
Despite its therapeutic effects, venlafaxine should be prescribed with care when lower dose is needed or treatment has to be stopped due to any reasons in order to prevent withdrawal syndrome.
Key words: venlafaxine, withdrawal, major depression.
1. Introduction
The treatment of mood disorders has been an active field of research for over 50 years. Many compounds with the promise to alleviate depression have been discovered and handfuls have been tested. Venlafaxine XR is a wide used dual-action serotonin-norepinephrine reuptake inhibitor antidepressant from and may be associated with a discontinuation syndrome. There are many side effects of venlafaxine XR data but very little about the effect of abrupt discontinuation of treatment. It acts as a serotonin reuptake inhibitor at doses below 150 mg and as a dual-action antidepressant from 150 to 300 mg, while at higher doses it acts on the dopamine and neurotransmitter systems.
Efficacy, safety, and tolerability of venlafaxine XR has been established for depression (Smith et al 2002), generalized anxiety disorder (Gelenberg et al 2000), and social anxiety disorder (Allgulander et al 2001).
In the vast majority of controlled trials the side-effects reported were: insomnia, constipation, dry mouth, anorexia, sweating, ejaculation or orgasm problems, somnolence, palpitations, vasodilatation, hypertension, nausea, (Khandker et al 2005, Bradwejn et al 2002, Katz et al 2002).
As with TCAs, MAOIs, and SSRIs, discontinuation symptoms have...