A patient who recently ran out of his antidepressant presents with dizziness, nausea, insomnia, irritability, and vivid 'electric shock' sensations in his head. Which antidepressant was he most likely taking?
- A Paroxetine ✓
- B Fluoxetine
- C Sertraline
- D Vortioxetine
Correct answer: A. Paroxetine
Explanation
Antidepressant discontinuation syndrome follows abrupt cessation, and its severity correlates inversely with the drug's half-life. Paroxetine has the shortest half-life among SSRIs (about 21 hours) and no active metabolite, so it produces the most frequent and severe discontinuation symptoms, including dizziness and sensory 'brain zaps'. Fluoxetine, with its long-lived metabolite norfluoxetine, almost never causes the syndrome and is even used to taper patients off other SSRIs.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.