Adverse Reactions & Pharmacovigilance

Withdrawal Syndrome

TRYoksunluk Sendromu
Also known as:Abstinence syndrome · Discontinuation syndrome

A characteristic cluster of signs and symptoms that follows abrupt discontinuation, rapid dose reduction or antagonist reversal of a drug to which the body has adapted during prolonged use.

In depth

Withdrawal reflects neuroadaptation (physical dependence): compensatory changes in receptors, signalling and transmitter release become unopposed when the drug is removed, so symptoms often oppose its acute effects. Short half-life drugs produce earlier, more intense but briefer syndromes. Physical dependence is an expected adaptation and is distinct from addiction.

Opioid withdrawal (lacrimation, rhinorrhoea, mydriasis, piloerection, diarrhoea) is distressing but rarely life-threatening in healthy adults, whereas alcohol, benzodiazepine, barbiturate and intrathecal baclofen withdrawal can cause seizures, delirium or death. Antidepressant discontinuation symptoms, including dizziness and sensory disturbances, are commonest with short half-life agents such as paroxetine and venlafaxine. An antagonist (naloxone) or partial agonist (buprenorphine) can precipitate acute withdrawal.

Clinical pearl

After prolonged use, benzodiazepines, opioids, antidepressants, gabapentinoids and baclofen should be tapered rather than stopped abruptly; unexplained agitation in hospitalised patients may reflect an omitted regular medicine.

Example drugs

Morphine Alprazolam Paroxetine Venlafaxine Baclofen
TRIn Turkish

Yoksunluk Sendromu

Uzun süreli kullanım sırasında vücudun uyum geliştirdiği bir ilacın aniden kesilmesi, dozunun hızla azaltılması veya etkisinin bir antagonistle tersine çevrilmesi sonrasında ortaya çıkan karakteristik belirti ve bulgular topluluğudur.

Yoksunluk nöroadaptasyonu (fiziksel bağımlılığı) yansıtır: reseptör, sinyal iletimi ve nörotransmiter salınımındaki kompansatuvar değişiklikler ilaç kesilince karşılıksız kalır; belirtiler bu nedenle çoğunlukla akut etkilerin tersidir. Kısa yarılanma ömürlü ilaçlarda tablo daha erken başlar, daha şiddetli ama kısa sürer. Fiziksel bağımlılık beklenen bir uyumdur ve addiksiyondan farklıdır.

Opioid yoksunluğu (gözyaşı ve burun akıntısı, midriyazis, piloereksiyon, ishal) sıkıntı verse de sağlıklı erişkinlerde nadiren yaşamı tehdit eder; alkol, benzodiazepin, barbitürat ve intratekal baklofen yoksunluğu ise nöbet, deliryum veya ölüme yol açabilir. Baş dönmesi ve duyusal bozukluklar gibi antidepresan kesilme belirtileri en sık paroksetin ve venlafaksin gibi kısa yarılanma ömürlü ajanlarla görülür. Nalokson (antagonist) veya buprenorfin (kısmi agonist) presipite yoksunluk oluşturabilir.

Uzun süreli kullanım sonrasında benzodiazepinler, opioidler, antidepresanlar, gabapentinoidler ve baklofen aniden kesilmemeli, azaltılarak kesilmelidir; hastanede yatan hastalarda açıklanamayan ajitasyon atlanan düzenli bir ilaca bağlı olabilir.

Diğer adları:Kesilme sendromu · Çekilme sendromu · Abstinens sendromu
Updated 24.09.2026 1 views Educational reference — verify against current sources before clinical use.

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TaperingAzaltarak Kesme

The gradual, planned reduction of a drug's dose over time before stopping it, to avoid withdrawal symptoms, rebound, disease flare or insufficient endogenous hormone production.

 Rebound EffectRebound Etkisi

The return of the condition being treated, at an intensity exceeding pre-treatment levels, after a drug is stopped or its dose is rapidly reduced.

 ToleranceTolerans

A gradual reduction in response to a drug with repeated or continuous exposure, so that a higher dose is needed to reproduce the original effect; it develops over days to weeks.

 Elimination Half-LifeEliminasyon Yarı Ömrü

The time required for the plasma concentration of a drug to decrease by 50% during the elimination phase, reflecting how long the drug remains active in the body.

 Receptor Up-RegulationReseptör Up-Regülasyonu

An increase in the number or sensitivity of receptors, typically after prolonged receptor blockade or reduced exposure to the endogenous agonist (e.g. denervation), leading to tissue supersensitivity.

 Partial AgonistKısmi Agonist

An agonist that, even when occupying all available receptors, produces a maximal response smaller than that of a full agonist; its intrinsic activity lies between 0 and 1.