Is dizziness a common symptom during paroxetine withdrawal? The questioner has recently treated two

Fråga: Is dizziness a common symptom during paroxetine withdrawal? The questioner has recently treated two patients with paroxetine (Seroxat) 20 mg daily due to depression. Both patients developed dizziness during three to five days after abrupt discontinuation of the medication.

Sammanfattning: Dizziness is a common withdrawal symptom after paroxetine treatment. The incidence might be higher in patients given increased doses and can be reduced by a gradual tapering.

Svar: The question about paroxetine and withdrawal symptoms has previously been answered (1). According to the manufacturer approximately five per cent of patients treated with paroxetine report symptoms after discontinuation of the drug. The most frequent symptoms are in decreasing order: dizziness, depression, paresthesia, gastrointestinal complaints, and increased sweating. These symptoms normally disappear within four to five days. If the patient has pronounced symptoms, the manufacturer recommends to reinstall the Seroxat treatment in the previous dose followed by a gradual tapering.

At the Swedish Adverse Drug Reactions Advisory Committee (SADRAC) a total of 29 reports of dizziness with a probable or possible causal relation to paroxetine treatment have been identified. It is, however, not possible to get information if the dizziness occurred during ongoing treatment or after withdrawal. In a recent letter to the Editor (2) three cases of dizziness accompanying paroxetine withdrawal in patients given high doses of paroxetine (50-60 mg daily) for treatment of obsessive compulsive disorder are described. In this letter it is further stated that dizziness accompanying paroxetine withdrawal has occurred in approximately one third of patients with obsessive compulsive disorders at this medical center.