Palinopsie nach Absetzen von Venlafaxin

Zusammenfassung

Wir berichten erstmals von einer Palinopsie nach Absetzen von Venlafaxin. Bei dieser seltenen und eigentümlichen Form der Sehstörung verschwinden gesehene Dinge verzögert aus dem Blickfeld, wodurch es zu irritierenden Überlagerungen, bis hin zum Schweifsehen, kommt. Palinopsie ist bekannt als Symptom einer Reihe von meist hirnorganischen Störungen, nach Konsum serotonerger Drogen sowie unter antiserotonergen Psychopharmaka. Absetzsymptome nach Behandlung mit Antidepressiva, insbesondere mit kurzer Halbwertszeit, sind seit Längerem bekannt, sollten aber im klinischen Alltag stärker beachtet werden. Bei Auftreten entsprechender Symptome bleibt sehr langsames Absetzen, gegebenenfalls über Wochen oder überlappend mit länger wirksamen serotonergen Antidepressiva, empfehlenswert.

Abstract

We report for the first time on a patient suffering from palinopsia after discontinuation of venlafaxine. Palinopsia is a rare and peculiar phenomenon which is defined as visual images that persist or recur after the stimulating object is removed and is often associated with posterior cerebral lesion or dysfunction. It also has been detected after usage of serotonergic drugs or in the course of antiserotonergic pharmacotherapy. Withdrawal symptoms after cessation of treatment involving serotonergic antidepressants are widely acknowledged in the literature, but still remain underestimated in clinical practice. It seems reasonable to suggest that clinicians should be aware of the risk of discontinuation symptoms in the case of serotonergic antidepressants, especially concerning those substances with a short half-life. If a decision is made to terminate therapy, it may be necessary to gradually reduce the dose over a number of weeks or to temporarily add a serotonin reuptake inhibitor with longer half-life.

Schlüsselwörter

Palinopsie - Absetzsymptome - Venlafaxin

Key words

palinopsia - withdrawal symptoms - venlafaxine

Literatur

• 1 Robert J, Miro O, Pedrol E, Cardellach F. Palinopsia as a manifestation of migraine associated with other symptoms.  Med Clin (Barc ). 1995;  105 76-77
• 2 Lefebre C, Kolmel H W. Palinopsia as an epileptic phenomenon.  Eur Neurol. 1989;  29 323-327
• 3 Johnson S F, Loge R V. Palinopsia due to nonketotic hyperglycemia.  West J Med. 1988;  148 331-332
• 4 Gates T J, Stagno S J, Gulledge A D. Palinopsia posing as a psychotic depression.  Br J Psychiatry. 1988;  153 391-393
• 5 Marneros A, Korner J. Chronic palinopsia in schizophrenia.  Psychopathology. 1993;  26 236-239
• 6 Ozsancak C, Auzou P. Palinopsia in Charles Bonnet syndrome.  Presse Med. 1998;  27 359
• 7 Kawasaki A, Purvin V. Persistent palinopsia following ingestion of lysergic acid diethylamide (LSD).  Arch Ophthalmol. 1996;  114 47-50
• 8 Kluver H. Mescal and Mechanisms of Hallucination (III). Chicago; University of Chicago Press 1966
• 9 McGuire P K, Cope H, Fahy T A. Diversity of psychopathology associated with use of 3,4-methylenedioxymethamphetamine („Ecstasy”).  Br J Psychiatry. 1994;  165 391-395
• 10 Gaillard M C, Borruat F X. Persisting visual hallucinations and illusions in previously drug-addicted patients.  Klin Monatsbl Augenheilkd. 2003;  220 176-178
• 11 Faber R A, Benzick J M. Nafazodone-induced palinopsia.  J Clin Psychopharmacol. 2000;  20 275-276
• 12 Ihde-Scholl T, Jefferson J W. Mitrazapine-associated palinopsia.  J Clin Psychiatry. 2001;  62 373
• 13 Hori H, Terao T, Nakamura J. Visual perseveration: a new side effect of maprotiline.  Acta Psychiatr Scand. 2000;  101 476-477
• 14 Hughes M S, Lessell S. Trazodone-induced palinopsia.  Arch Ophthalmol. 1990;  108 399-400
• 15 Lauterbach E C, Abdelhamid A, Annandale J B. Posthallucinogen-like visual illusions (palinopsia) with risperidone in a patient without previous hallucinogen exposure: possible relation to serotonin 5HT2a receptor blockade.  Pharmacopsychiatry. 2000;  33 38-41
• 16 Evans R W. Reversible palinopsia and the Alice in Wonderland syndrome associated with topiramate use in migraineurs.  Headache. 2006;  46 815-818
• 17 Purvin V A. Visual disturbance secondary to clomiphene citrate.  Arch Ophthalmol. 1995;  113 482-484
• 18 Friedman D I, Hu E H, Sadun A A. Neuro-ophthalmic complications of interleukin 2 therapy.  Arch Ophthalmol. 1991;  109 1679-1680
• 19 Ditto K E. SSRI discontinuation syndrome. Awareness as an approach to prevention.  Postgrad Med. 2003;  114 79-84
• 20 Agelink M W, Zitzelsberger A, Klieser E. Withdrawal syndrome after discontinuation of venlafaxine.  Am J Psychiatry. 1997;  154 1473-1474
• 21 Pinzani V, Ginies E, Robert L, Peyriere H, Abbar M, Blayac J P. Venlafaxine withdrawal syndrome: report of six cases and review of the literature.  Rev Med Interne. 2000;  21 282-284
• 22 Johnson H, Bouman W P, Lawton J. Withdrawal reaction associated with venlafaxine.  BMJ. 1998;  317 787
• 23 Strickland G M, Hough D W. Unilateral facial numbness and visual blurring associated with paroxetine discontinuation.  J Clin Psychopharmacol. 2000;  20 271-272
• 24 Black D W, Wesner R, Gabel J. The abrupt discontinuation of fluvoxamine in patients with panic disorder.  J Clin Psychiatry. 1993;  54 146-149
• 25 Boyd I W. Venlafaxine withdrawal reactions.  Med J Aust. 1998;  169 91-92