Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Diagnosis and Preventions

Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor(SSRIs) are a types of  antidepressant medications to treat depression and certein neurological disorders, including  obsessive-compulsive disorder, panic disorder (PD), generalised anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD), etc..

SSRI discontinuation syndrome is defined as a condition of a syndrome as a result of interruption, reduced doses or discontinuation of any anti depressant medication, including SSRI (selective serotonin re-uptake inhibitor) and serotonin–norepinephrine reuptake inhibitor (SNRI), researchers  showed that The SSRI discontinuation syndrome is a characteristic selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome appears to exist. It is usually mild, commences within 1 week of stopping treatment, resolves spontaneously within 3 weeks, and consists of diverse physical and psychological symptoms, the commonest being dizziness, nausea, lethargy and headache. SSRI reinstatement leads to resolution within 48 h(1).

III. Diagnosis
There are no specific diagnosis criteria, but researchers in the study of "Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria", suggested that the criteria are 2 or more of the following symptoms developing within 1 to 7 days of discontinuation or reduction in dosage of an SSRI after at least 1 month's use, when these symptoms cause clinically significant distress or impairment and are not due to a general medical condition or recurrence of a mental disorder: dizziness, light-headedness, vertigo or feeling faint; shock-like sensations or paresthesia; anxiety; diarrhea; fatigue; gait instability; headache; insomnia; irritability; nausea or emesis; tremor; and visual disturbances(11).

IV. Prevention
B. Diet to reduce the symptoms of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
B.1. Foods to Increase Serotonin
Various fruits boost serotonin and other mood-improving chemicals in the brain, including
The following fruits had a high serotonin concentration (mean +/- SEM) expressed in micrograms/g weight: plantain 30.3 +/- 7.5; pineapple 17.0 +/- 5.1; banana 15.0 +/- 2.4; Kiwi fruit 5.8 +/- 0.9; plums 4.7 +/- 0.8; and tomatoes 3.2 +/- 0.6. Only nuts in the walnut or hickory family had a high serotonin concentration expressed in micrograms/g weight; butternuts 398 +/- 90; black walnuts 304 +/- 46; English walnuts 87 +/- 20; shagbark hickory nuts 143 +/- 23; mockernut hickory nuts 67 +/- 13; pecans 29 +/- 4; and sweet pignuts 25 +/- 8. Ingestion of these fruits and nuts resulted in an increase in urinary 5-hydroxyindoleacetic acid excretion with no change in platelet serotonin concentration(13).