The rebound effect, or rebound phenomenon, is the tendency of some medications, in sudden discontinuation, to cause a return of the symptoms it relieved, and that, 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 Medications with a known rebound effect can be withdrawn gradually, or, in conjunction with another medication that does not exhibit a rebound effect.

Examples[link]

Sedative hypnotics[link]

Rebound anxiety

Several anxiolytics and hypnotics have a rebound effect: For example, benzodiazepine withdrawal can cause severe anxiety and insomnia worse than the original insomnia or anxiety disorder.^[1] Approximately 70% of patients who discontinue a benzodiazepine experience a rebound effect.^[2] Rebound withdrawal can be a factor in chronic use of medications and drug dependence with patients taking the medications only to ward off withdrawal or rebound withdrawal effects.^[3]

Rebound insomnia

Rebound insomnia is insomnia that occurs following discontinuation of sedative substances taken to relieve primary insomnia. Regular use of these substances can cause a person to become dependent on its effects in order to fall asleep through the process of classical conditioning. Therefore, when a person has stopped taking the medication and is 'rebounding' from its effects, he or she may experience insomnia as a symptom of withdrawal. Occasionally, this insomnia may actually be worse than the insomnia the drug was intended to treat.^[4]

Common medicines known to cause this problem are Eszopiclone and Zolpidem, which are prescribed to people having difficulties falling or staying asleep. This phenomenon can also occur with regular use of anxiolytic drugs, such as benzodiazepines.

Daytime rebound

Rebound phenomena does not necessarily only occur on discontinuation of a prescribed dosage. For example day time rebound effects of anxiety, metallic taste, perceptual disturbances which are typical benzodiazepine withdrawal symptoms can occur the next day after a short acting benzodiazepine hypnotic wears off. Another example is early morning rebound insomnia which may occur when a rapidly eliminated hypnotic wears off which leads to rebounding awakeness forcing the person to become wide awake before he or she has had a full night's sleep. One drug which seems to be commonly associated with these problems is triazolam due to its high potency and ultra short half life but these effects can occur with other short acting hypnotic drugs.^[5][6][7] Quazepam due to its selectivity for type1 benzodiazepine receptors and long half life does not cause day time anxiety rebound effects during treatment, showing that half life is very important for determining whether a night time hypnotic will cause next day rebound withdrawal effects or not.^[8] Day time rebound effects are not necessarily mild but can sometimes produce quite marked psychiatric and psychological disturbances.^[9]

Stimulants[link]

Rebound effects can also occur from stimulants such as methylphenidate or dextroamphetamine. Rebound effects from these medications can include psychosis, depression and a return of ADHD symptoms but in a temporarily exaggerated form.^[10][11][12] Up to a third of ADHD children experience a rebound effect when methylphenidate is withdrawn.^[13]

Antidepressants[link]

Many antidepressants, such as SSRIs, can cause rebound depression and/or panic attacks and anxiety when discontinued.^[14]

alpha-2 adrenergic agents[link]

Rebound effects can occur after discontinuation of alpha-2 adrenergic agents such as clonidine and guanfacine. The most notable rebound effect of alpha-2 adrenergic agents is rebound hypertension.^[15]

Others[link]

Other rebound effects

An example is the use of highly potent corticosteroids, such as Clobetasol for psoriasis. Abrupt withdrawal can cause a much more severe case of the psoriasis to develop. Therefore, withdrawal should be gradual, diluting the medication with lotion perhaps, until very little actual medication is being applied.

Another example of pharmaceutical rebound is a rebound headache from painkillers when dose is lowered, medication wears off or the drug is abruptly discontinued.^[16]

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

See also[link]

• Physical dependence
• Rebound headache
• Withdrawal syndrome
• Rhinitis medicamentosa

References[link]

Scott Owen
Owen performing in Chicago in 2004
Background information
Born	(1975-02-14) 14 February 1975 (age 37)
Origin	Melbourne, Victoria, Australia
Occupations	Bassist
Instruments	Double bass, vocals
Years active	1992 - Present
Associated acts	The Living End

Scott Bradley Owen (born 14 February 1975) plays the double bass in the Australian rock band The Living End. After playing the piano for many years, he decided that the keys would not work for a rockabilly band, so at age 17 he purchased and taught himself double bass, letting him play rockabilly with best friend and band mate, Chris Cheney.

During their live shows, Owen is known for pulling his "bass stunts", most notably standing on the bass (or letting Chris Cheney stand on it), tilting it on an angle, resting his right foot on the curve by the f-hole and his left foot over the belly of the bass near the bottom of the fingerboard.

Scott has two children, Harvey and Ginger, with his wife Emilie.

Owen has also written a number of tracks for The Living End including: "Flood The Sky", "I Want A Day", "What Would You Do?" and "Stay Away From Me". He also co-wrote "So Lonely" and "Black Cat" with Chris Cheney and "Short Notice" and "E-Boogie" with Chris Cheney and Andy Strachan.

He played double bass for Paul Kelly on his song Song Of The Old Rake and features in the filmclip, set in a Bendigo radio station.

Owen uses Ampeg cabinets and heads, separate channels for bass and slap pickups.^[1]

References[link]

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