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Dilsaver, 1983 Antidepressant withdrawal syndromes: evidence supporting the cholinergic overdrive hypothesis.


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This is why the new generation antidepressants -- the SSRIs -- were thought not to have a withdrawal syndrome: None of them is significantly anticholinergic but paroxetine.


However, it turns out that this hypothesis is wrong. While cholinergic rebound may be involved in withdrawal from cholinergic antidepressants, other factors, such as downregulation of serotonin receptors, probably play a larger role.


J Clin Psychopharmacol. 1983 Jun;3(3):157-64.
Antidepressant withdrawal syndromes: evidence supporting the cholinergic overdrive hypothesis.
Dilsaver SC, Kronfol Z, Sackellares JC, Greden JF.

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/6348107

The authors present case examples of the various antidepressant withdrawal syndromes. Substantial evidence supports the contention that these syndromes result from cholinergic overdrive; thus, they may have a common pathophysiological basis. Even paradoxical reactions on antidepressant withdrawal, such as mania, are consistent with the cholinergic overdrive hypothesis. If the cholinergic overdrive hypothesis of affective illness. The cholinergic overdrive hypothesis is both of considerable heuristic value and is further testable by the study of the tonic and phasic aspects of sleep and neuroendocrine parameters in the withdrawal state.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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