Rebound effect

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Rebound syndrome
)
This article is about the pharmacological term. For the energy conservation term, see Rebound effect (conservation).

The rebound effect, or rebound phenomenon, is the emergence or re-emergence of

symptoms
that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage. In the case of re-emergence, the severity of the symptoms is often worse than pretreatment levels.

Definition

The rebound effect, or

symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage. In the case of re-emergence, the severity of the symptoms is often worse than pretreatment levels.[citation needed
]

Examples

Sedative hypnotics

Rebound insomnia is

benzodiazepines
and which are prescribed to people having difficulties falling or staying asleep.

Rebound depression may appear to arise in patients previously free of such an illness.[2]

Daytime rebound effects of anxiety, metallic taste, perceptual disturbances which are typical

hypnotic drugs.[3][4][5] Quazepam, due to its selectivity for type1 benzodiazepine receptors and long half-life, does not cause daytime anxiety rebound effects during treatment, showing that half-life is very important for determining whether a nighttime hypnotic will cause next-day rebound withdrawal effects or not.[6] Daytime rebound effects are not necessarily mild but can sometimes produce quite marked psychiatric and psychological disturbances.[7]

Stimulants

Rebound effects from

depression and a return of ADHD symptoms but in a temporarily exaggerated form.[8][9][10] Up to a third of ADHD children experience a rebound effect when methylphenidate is withdrawn.[11]

Antidepressants

Many

panic attacks, anxiety, and insomnia when discontinued.[12]

Antipsychotics

Sudden and severe emergence[13] or re-emergence[14] of psychosis may appear when antipsychotics are switched or discontinued too rapidly.

Alpha-2 adrenergic agents

Rebound hypertension, above pre-treatment level, was observed after clonidine,[15] and guanfacine[16] discontinuation.

Continuous usage of topical decongestants (nasal sprays) can lead to constant nasal congestion, known as rhinitis medicamentosa.

Other medications

Another example of

rebound headache from painkillers when the dose is lowered, the medication wears off, or the drug is abruptly discontinued.[17]

In 2022, reports of viral RNA and symptom rebound in people with

Paxlovid were published. In May, CDC even issued a health alert informing physicians about "Paxlovid rebounds", which received attention when US president Joe Biden experienced a rebound. The cause of the rebound is unclear however, since around a third of people with COVID-19 experience a symptom rebound regardless of treatment.[18]

Abrupt withdrawal of highly potent corticosteroids, such as clobetasol for psoriasis can cause a much more severe case of the psoriasis to develop. Therefore, withdrawal should be gradual, until very little actual medication is being applied.[citation needed]

See also

References

  1. ISBN 0-14-051451-1
    .
  2. PMID 7799243
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  3. PMID 6131538
    .
  4. PMID 2895786
    .
  5. S2CID 33505418
    .
  6. PMID 1680120
    .
  7. S2CID 32045254
    .
  8. S2CID 38304694
    .
  9. PMID 760559
    .
  10. PMID 11563573. Archived from the original
    on 2008-05-13. Retrieved 2009-04-27.
  11. PMID 11514638. Archived from the original
    on 2012-07-14.
  12. PMID 16456219. Archived from the original
    (PDF) on 2006-04-12.
  13. S2CID 11574536
    .
  14. S2CID 6267180. Archived from the original
    on 5 January 2013. Retrieved 3 May 2009.
  15. PMID 3026180
    . Retrieved 5 December 2012.
  16. PMID 18295156
    .
  17. PMID 15617293
    .
  18. ^ Reynolds Lewis (2022-08-02). "Covid rebound can happen even in people who haven't taken Paxlovid". Retrieved 2022-08-04.
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