Summary
Chronic diseases often require long-lasting pharmacotherapy. Administration of some medicines on a daily routine may cause troublesome adverse effects thus discouraging the patient from further treatment. An abrupt withdrawal of formerly continuous pharmacotherapy not proceeded by the professional medical consultation may endanger the patient either due to the relapse of the disease or the onset of withdrawal symptoms that, despite some opinions, are not limited only to potentially addictive medications.
These symptoms may be mistaken for a clinical manifestation of a yet another medical condition of the ill leading to a vicious cycle of repeated diagnostics – additional pharmacotherapy – discontinuation of treatment due to drug intolerance – novel symptoms – repeated diagnostics etc., especially in the elderly.
Unfortunately, even some medical doctors tend to forget that administration of specific drugs should not be stopped suddenly because certain withdrawal symptoms are more harmful than mild drug-induced adverse reactions. On the other hand, this is the clinician’s individual decision whether to stop or to continue the treatment in the presence of drug intolerance reported by the patient as many “practical” guidelines either do not give any recommendations or the statements are too general to be helpful in every-day practice. Therefore, the authors review the data on the causative factors and clinical implications of a sudden drug withdrawal, including mainly stricte non-addictive medicines in use for diseases of high incidence in general population.