Drugs with Rebound Phenomenon
➧ The rebound effect, or rebound phenomenon, is the tendency of some medications, in sudden discontinuation, to cause a return of the symptoms it relieved, to a degree stronger than they were before treatment first began. Medications with a known rebound effect can be withdrawn gradually, or, in conjunction with another medication that does not exhibit a rebound effect.
1-Sedative Hypnotics:
-Benzodiazepine withdrawal can cause rebound anxiety and insomnia.
-Eszopiclone and Zolpidem) can cause rebound insomnia.
2-Stimulants:
➧ e.g. Methylphenidate or Dextroamphetamine
➧ Rebound effects include psychosis, depression, and a return of ADHD symptoms but in a temporarily exaggerated form.
3-Antidepressants:
➧ e.g. SSRIs
➧ Cause rebound depression and/or panic attacks and anxiety when discontinued.
4-Alpha-2 adrenergic agents:
➧ e.g. Clonidine and Guanfacine
➧ The most notable rebound effect is rebound hypertension.
5-Beta-adrenergic antagonists:
➧ e.g. Bisoprolol
➧ Sudden withdrawal leads to rebound tachycardia and anginal pain.
6-Highly potent corticosteroids:
➧ e.g. Clobetasol for psoriasis
➧ Abrupt withdrawal can cause rebound psoriasis and hypoglycemia.
7-Warfarin:
➧ Withdrawal leads to thromboembolism
8-Alcohol:
➧ Withdrawal leads to alcohol withdrawal syndrome: (anxiety and convulsions).
9- Painkillers:
➧ Withdrawal can cause rebound headaches.
10-Topical decongestants:
➧ Nasal sprays e.g. Phenylephrine
➧ Continuous usage can lead to constant nasal congestion, known as Rhinitis medicamentosa, and discontinuation to rebound nasal congestion.
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