A patient who abruptly stops paroxetine after two years of therapy experiences dizziness, electric shock-like sensations, and nausea. Discontinuation syndrome is most severe with paroxetine compared to other SSRIs because paroxetine:
- A Has the longest half-life
- B Inhibits CYP2D6
- C Has the shortest half-life ✓
- D Is a prodrug
Correct answer: C. Has the shortest half-life
Explanation
Discontinuation syndrome occurs due to rapid drops in serotonin levels upon abrupt cessation. Paroxetine has the shortest half-life among SSRIs and lacks an active metabolite, leading to rapid clearance and severe symptoms. Fluoxetine, with its long half-life and active metabolite norfluoxetine, rarely causes this syndrome. CYP2D6 inhibition does not influence discontinuation severity.
Reference: Katzung and Trevor's Pharmacology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.