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
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Dr. med. Peter Ernst Spindler
Klinik und Poliklinik für Psychiatrie, Universitätsklinikum Leipzig
Liebigstraße 22 b
04103 Leipzig
Email: peter.spindler@medizin.uni-leipzig.de