Which of the following psychotropic drugs is most likely to produce a severe withdrawal syndrome when suddenly discontinued?
High-Yield Explanation
Sho-acting benzodiazepines such as alprazolam can produce significant symptoms when abruptly discontinued, a sign of physiological dependence. Mild symptoms can include anxiety, irritability, sleep disruption, tremor, and nausea; the development of seizures is a serious complication of sudden drug withdrawal. The likelihood of significant withdrawal symptoms increases with dosage and length of treatment. A discontinuation syndrome has been seen in some persons on long-term high-dose tricyclic antidepressants (amitriptyline) when the medication is stopped abruptly. Symptoms include anxiety, insomnia, headache, chills, nausea. No serious complications occur. The symptoms may be prevented by tapering off the antidepressant. Ref: Tsutaoka B. (2012). Chapter 31. Benzodiazepines. In K.R. Olson (Ed), Poisoning & Drug Overdose, 6e.