Antidepressant discontinuation syndrome is a set of symptoms that can occur after an abrupt cessation (or marked reduction in dose) of an antidepressant medication that was taken continuously for at least 1 month. Symptoms generally begin within 2-4 days and typically include specific sensory and cognitive-emotional effects. Frequently reported symptoms to include flashes of light, “electric shock” sensations, nausea, and hyperresponsivity to noises or lights. Feelings of anxiety and dread may also be reported. Symptoms are alleviated by restarting the same medication or starting a different mediation that has a similar mechanism of action.

What is Nocturnal Myoclonus (or Periodic Leg Movements During Sleep)?

Nocturnal myoclonus, also known as “periodic leg movements during sleep” is repetitive cramping or jerking of the legs during sleep. Individuals are unaware of the leg jerks. The condition may be present in about 40 percent of persons over the age of 65. The cause is unknown, but it is a rare side effect of SSRIs. The repetitive leg movements occur every 20 to 60 seconds, with extensions of the large toe and flexing of the ankle, knee, and hips. Frequent awakenings, unrefreshing sleep, and daytime sleepiness are major symptoms. No treatment for nocturnal myoclonus is universally effective. Treatments that may be useful include benzodiazepines, levodopa (Larodopa), quinine, and, in rare cases, opioids.

What is Restless Leg Syndrome?

In restless leg syndrome, individuals feel deep sensations creeping inside the calves whenever sitting or lying down. The sensations are rarely painful but are relentless and cause an almost irresistible urge to move the legs. Thus, the syndrome interferes with sleep. It peaks in middle age and occurs in 5 percent of the population. The cause is unknown, but it is a rare side effect of SSRIs. Symptoms are relieved by movement and by leg massage. The dopamine receptor agonists ropinirole (Requip) and pramipexole (Mirapex) are effective in treating this syndrome. Other treatments include benzodiazepines, levodopa, quinine, opioids, propranolol, valproate, and carbamazepine.