Qelbree Discontinuation Management
Based on available evidence, Qelbree (viloxazine extended-release) can be discontinued abruptly without requiring a gradual taper, as there is no documented withdrawal syndrome or discontinuation symptoms specific to this medication.
Current Evidence on Qelbree Discontinuation
The available literature on viloxazine extended-release does not describe a specific discontinuation syndrome or withdrawal symptoms associated with stopping this medication 1. Unlike other psychiatric medications such as antidepressants or benzodiazepines, there are no published guidelines or FDA warnings regarding tapering requirements for Qelbree.
Key Clinical Considerations
No Established Withdrawal Syndrome
- Qelbree is a selective norepinephrine reuptake inhibitor approved for pediatric ADHD that does not share the pharmacological profile of medications known to cause significant discontinuation symptoms 1
- There is no evidence in the current literature documenting physical or psychological withdrawal symptoms upon cessation
Practical Discontinuation Approach
Given the absence of specific guidance, clinicians should:
- Monitor for symptom recurrence: The primary concern when stopping Qelbree is the return of ADHD symptoms rather than withdrawal effects
- Watch for mood or behavioral changes: While not documented as withdrawal, monitor for any unexpected psychological symptoms in the weeks following discontinuation
- Consider clinical context: If discontinuing due to adverse effects or lack of efficacy, abrupt cessation is reasonable
Contrast with Other Psychiatric Medications
Unlike antidepressants, which require gradual tapering over weeks to months to prevent discontinuation syndrome characterized by dizziness, flu-like symptoms, mood disturbances, and paresthesias 2, Qelbree does not have documented requirements for dose reduction strategies 3, 4.
Clinical Pitfall to Avoid
Do not confuse the return of underlying ADHD symptoms (inattention, hyperactivity, impulsivity) with withdrawal symptoms. These represent the natural course of untreated ADHD rather than a medication discontinuation syndrome.