Palinopsie nach Absetzen von Venlafaxin

 

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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.

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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