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Sunday, 1 December 2013

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Treatments InTraditional Chinese medicine perspective

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).
Treatments
C. In traditional Chinese medicine perspective
According to APPENDIX 1: Guipi Tang and SSRI Withdrawal Syndrome, Western interpretation of the symptoms as relative deficiency in serotonin availability or an imbalance of neurotransmitters after the drugs are removed. In TCM the withdrawal syndrome may be caused qi and blood deficiency, as a result of the spleen (for qi) and liver (for blood). Treatment of SSRI withdrawal syndrome is depending to the differentiation of the symptom(29). Herbs used include
Atractylodes (white atractylodes): tonifies qi, resolves damp
Peony (white peony): nourishes blood, vitalizes blood circulation
Tang-kuei: nourishes blood, vitalizes blood circulation
Zizyphus: nourishes liver and heart blood and clams shen
Saussurea: circulates qi, calms shen
Ginseng: tonifies qi, calms shen
Astragalus: tonifies qi, raises yang qi
Polygala: resolves phlegm, calms shen
Fu-shen or Hoelen: resolves damp, calms shen
Pinellia: resolves damp, lowers stomach qi
Citrus: resolves damp, circulates qi 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(29) http://www.dr-bob.org/babble/alter/20100516/msgs/947782.html