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Sunday, 1 December 2013

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Diagnosis and the Diet

Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor (SSRIs) are a types of  antidepressant medications to treat depression and certain neurological disorders, including  obsessive-compulsive disorder, panic disorder (PD), generalized anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD), etc..

SSRI discontinuation syndrome is defined as a condition of a syndrome as a result of interruption, reduced doses or discontinuation of any anti depressant medication, including SSRI (selective serotonin re-uptake inhibitor) and serotonin–norepinephrine reuptake inhibitor (SNRI), researchers  showed that The SSRI discontinuation syndrome is a characteristic selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome appears to exist. It is usually mild, commences within 1 week of stopping treatment, resolves spontaneously within 3 weeks, and consists of diverse physical and psychological symptoms, the commonest being dizziness, nausea, lethargy and headache. SSRI reinstatement leads to resolution within 48 h(1).
Diagnosis
There are no specific diagnosis criteria, but researchers in the study of "Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria", suggested that the criteria are 2 or more of the following symptoms developing within 1 to 7 days of discontinuation or reduction in dosage of an SSRI after at least 1 month's use, when these symptoms cause clinically significant distress or impairment and are not due to a general medical condition or recurrence of a mental disorder: dizziness, light-headedness, vertigo or feeling faint; shock-like sensations or paresthesia; anxiety; diarrhea; fatigue; gait instability; headache; insomnia; irritability; nausea or emesis; tremor; and visual disturbances(11).
Diet to reduce the symptoms of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
B.1. Foods to Increase Serotonin
Various fruits boost serotonin and other mood-improving chemicals in the brain, including
The following fruits had a high serotonin concentration (mean +/- SEM) expressed in micrograms/g weight: plantain 30.3 +/- 7.5; pineapple 17.0 +/- 5.1; banana 15.0 +/- 2.4; Kiwi fruit 5.8 +/- 0.9; plums 4.7 +/- 0.8; and tomatoes 3.2 +/- 0.6. Only nuts in the walnut or hickory family had a high serotonin concentration expressed in micrograms/g weight; butternuts 398 +/- 90; black walnuts 304 +/- 46; English walnuts 87 +/- 20; shagbark hickory nuts 143 +/- 23; mockernut hickory nuts 67 +/- 13; pecans 29 +/- 4; and sweet pignuts 25 +/- 8. Ingestion of these fruits and nuts resulted in an increase in urinary 5-hydroxyindoleacetic acid excretion with no change in platelet serotonin concentration(13).
B.2. Serotonin Boost from Protein Sources
Food contain high levels of tryptophan such asTurkey, Lean beef, Salmon, etc. can enhance the production of the levels of serotonin, as trytophan ia a precursor of the sorotonin. Some researchers showed  that tryptophan is an antidepressant in mild to moderate depression and a small body of data suggests that it can also decrease aggression. Preliminary data indicate that tryptophan also increases dominant behavior during social interactions. Overall, studies manipulating tryptophan levels support the idea that low serotonin can predispose subjects to mood and impulse control disorders. Higher levels of serotonin may help to promote more constructive social interactions by decreasing aggression and increasing dominance(14).

B.3. Carbohydrate-based Foods and carbohydrate snacking that Increase Serotonin
Carbohydrate-based Foods and carbohydrate snacking found abundantly in foods consists of glucose that can boost serotonin production. Evidence is presented that carbohydrate snacking seems to be related to a "need" to increase the level of brain serotonin; treatment with a drug, d-1 fenfluramine, that increases serotoninergic neurotransmission significantly decreases carbohydrate snack consumption(15).

B.4. Etc.
 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(11) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1407715/
(12) http://www.circlemedhealthcare.com/ssri.pdf
(13) http://www.ncbi.nlm.nih.gov/pubmed/2413754
(14) http://www.ncbi.nlm.nih.gov/pubmed/11888576
(15) http://www.ncbi.nlm.nih.gov/pubmed/6381575