Activation syndrome

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Activation syndrome is a form of stimulation (sometimes suicidal) or agitation that has been observed in association with some psychoactive drugs.[1] A causative role has not been established.[2] Pfizer has denied that sertraline can cause such effects.[3][4]


Serotonin reuptake inhibitors (SSRI) have been used in the induction of an "activation syndrome" (restlessness, labiality, etc.). The syndrome generally represents a state change that encourages suicidal tendencies in people under age 25 during the initial weeks of treatment.[5] SSRI-induced activation syndrome is well-accepted by clinicians.[6] Evidence reveal that jitteriness/anxiety syndrome predicts an improved prognosis (level D). Further, people with panic disorder with the syndrome may tolerate doses of tricyclic antidepressants without affecting outcome level D.[7] Activation syndrome resolves within hours of discontinuing the serotonergic agent and initiating care. However, drugs with half-lives may cause symptoms to persist. Monoamine oxidase inhibitors (MAOIs) carry the risk, and symptoms persist for several days.[8]