Objective: To demonstrate that when antidepressants are switched, discontin
uation symptoms from the first antidepressant may be misdiagnosed as advers
e effects of the second antidepressant.
Method: Single case report.
Results: A female patient was switched from paroxetine to dothiepin due to
lack of efficacy. Over the next week she developed physical symptoms which
she and her doctor regarded as side effects of dothiepin. It was decided to
change the dothiepin and a second opinion was obtained regarding a suitabl
e alternative. At that point it was realized that her symptoms represented
a paroxetine discontinuation syndrome. The patient was reassured and contin
ued dothiepin. The discontinuation symptoms resolved over the next 3 weeks
and her depression subsequently remitted.
Conclusion: Increased professional awareness of discontinuation symptoms is
necessary to prevent misdiagnosis and inappropriate treatment.