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首页> 外文期刊>The journal of clinical psychiatry >Physiologic mechanisms underlying the antidepressant discontinuation syndrome.
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Physiologic mechanisms underlying the antidepressant discontinuation syndrome.

机译：抗抑郁药停药综合症的生理机制。

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The rate at which serotonin reuptake inhibitor (SRI) treatment is terminated and the duration of treatment appear to be key factors in predicting discontinuation symptoms. The development of animal models to explain the mechanisms of this clinical problem has proved challenging, because less than half of all patients experience any discontinuation symptoms, many of which are subjective in nature. One explanation is that SRI discontinuation symptoms may arise from the rapid decrease in serotonin (5-HT) availability when treatment ends abruptly. Yet, it would appear that discontinuation discomforts may not be mediated exclusively through 5-HT receptors, given the major regulatory role 5-HT exerts on a number of specific chemical receptor systems in the brain. As a result, attempts to explain the determinants of this phenomenon rely on a certain level of speculation. This article examines the possible physiologic bases for the antidepressant discontinuation syndrome and briefly describes these adaptations. It discusses the 3 systems most likely to account for at least part of the symptomatology--the 5-HT, the norepinephrine, and the cholinergic systems--and the possible interactions among them. It also attempts to explain their implications in the therapeutic actions of antidepressants in patients with affective and anxiety disorders.
机译：血清素再摄取抑制剂（SRI）治疗终止的速率和治疗的持续时间似乎是预测停药症状的关键因素。解释这种临床问题机理的动物模型的开发已被证明具有挑战性，因为不到一半的患者会经历任何停药症状，其中许多是主观的。一种解释是，当治疗突然终止时，血清素（5-HT）利用率迅速下降可能会导致SRI终止症状。但是，鉴于5-HT对大脑中许多特定化学受体系统的主要调节作用，看来终止不适可能并非仅通过5-HT受体来介导。结果，试图解释这种现象的决定因素的尝试依赖于一定程度的推测。本文研究了抗抑郁药停药综合症的可能生理基础，并简要介绍了这些适应症。它讨论了最有可能解释至少一部分症状的3种系统-5-HT，去甲肾上腺素和胆碱能系统-以及它们之间可能的相互作用。它还试图解释它们对情感和焦虑症患者抗抑郁药治疗作用的意义。

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