We report two patients who developed a severe discontinuation (withdrawal)
reaction following stoppage of paroxetine and venlafaxine, respectively. Ne
urological symptoms were prominent and neither patient could walk unaided.
Both patients feared they had suffered a 'stroke' and arranged an emergency
medical consultation. One patient was correctly diagnosed, the antidepress
ant was recommenced and symptoms resolved within 24 h. Failure to recognize
the reaction resulted in the other patient being referred to a neurologist
, undergoing a computed tomography brain scan and an electroencephalogram a
nd remaining symptomatic for over 8 weeks. Relevant pharmacological issues
are discussed. The cases illustrate the importance of patients and clinicia
ns being familiar with antidepressant discontinuation symptoms.