A 30-year-old woman stops her antidepressant abruptly and within 2 days develops dizziness, electric shock sensations, nausea, irritability and insomnia. Which drug, if she had been taking it, would have made this withdrawal syndrome LEAST likely?
- A Paroxetine
- B Venlafaxine
- C Fluoxetine ✓
- D Sertraline
Correct answer: C. Fluoxetine
Explanation
Discontinuation severity parallels how quickly serotonergic activity falls. Fluoxetine has an extremely long half-life (its active metabolite norfluoxetine lasts 1 to 2 weeks), so it tapers itself and rarely causes withdrawal. Paroxetine has the shortest half-life among SSRIs and causes the most severe discontinuation symptoms; venlafaxine, though an SNRI, is also notorious for this. Sertraline carries intermediate risk.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.