The rebound effect is specifically important after discontinuation of a prolonged medication. Mechanisms originally intended for the body’s adaptation can lead to undesirable side effects in medicine and other fields.
What is the rebound effect?
The rebound effect is a consequence of giving up a habit. In medicine, the focus here is when a medication lasts longer, because then the body gets used to it and stopping the medication triggers the rebound. In abstract terms, the rebound effect is a consequence of giving up a habit. In medicine, the focus here is on when a medication lasts longer, because then the body gets used to it and discontinuing the medication triggers the rebound: The originally treated symptoms often occur to a higher degree than before the medication. This is why the term “discontinuation effect” is used synonymously. In the case of addiction, rebound can occur when the addiction continues to be served in order to avoid withdrawal symptoms. These become all the greater after the addictive substance is discontinued (rebound), so that the addiction must continue to be pursued. The discontinuation effect also occurs with hormonal treatments. It can be found particularly vividly in physiology, where a patient presses down on a doctor’s arm with his arm. If the latter initially withstands the pressure, the patient becomes accustomed to this condition. If the counterpressure is suddenly reduced, there is an abrupt stop in the application of force on both sides and the patient’s arm shoots slightly upward (rebound).
Function and task
Here, the abstract basic structure of the weaning effect becomes apparent: the body becomes accustomed to a situation. When it is changed, it cannot compensate properly at first. Various mechanisms can be the cause of this: With a medication, the receptors that respond to the active ingredient may decrease in number. The body becomes numb to the drug and may need a higher dose. Upon discontinuation, the body’s own active ingredients may subsequently bind to fewer receptors. Where there was a deficit before that made the medication necessary, the deficiency is even greater afterwards. But the opposite can also occur: Upregulation can occur, an upregulation of the number of receptors. The body learns to respond to the drug, it becomes more sensitive to it, but also gets used to the higher turnover. When the drug is discontinued, it is therefore undersupplied, and rebound occurs. The high adaptability of the human body is a vital characteristic. In this way, it can compensate for a large number of environmental changes and adapt to a wide variety of environmental conditions. In the case of abrupt changes, however, it needs a period of adjustment. The discontinuation effect therefore only occurs when a drug is discontinued too quickly. It is avoided if the drug is phased out over a longer period of time. Rebound is therefore a kind of tribute to adaptability, without which humans would be immensely more sensitive and fragile. This effect can be observed not only in medicine, but also in psychology, for example. If the psyche has become accustomed to an environment, a brash change in life can make the accustomed state all the more lacking. Similarly, if someone moves from a very cold region to a very warm region and later back again, this is a kind of rebound. He will feel more cold when he returns home, because he has adapted to the hot climate in the meantime.
Diseases and ailments
Rebounds occur with a variety of medications. When discontinuing sedative, anxiety-relieving benzodiazepines, the patient may be more anxious than before the medication. After discontinuing the administration of cardiac-regulating beta-blockers, the patient may experience palpitations. Those who have gastritis and are taking proton pump inhibitors, which reduce gastric acid, may observe increased gastric acid production after discontinuation. After discontinuing mucosal decongestant nasal sprays that dry out the nasal mucosa, the mucosa may swell to a particular degree and the nose may become congested again. After treating a goiter with thyroxine, the thyroid gland grows again. All of these are examples where patients exhibit some sort of dependence on the drug, requiring gradual withdrawal, tapering off. Here the similarity to an addiction becomes clear.In the case of addiction, however, the targeted seeking of an effect by a substance is in the foreground; withdrawal is secondary as a consequence. In the case of drug rebound, it is the other way around, withdrawal is primary. Rebound effects are also found in the extra-medical field. In alcohol withdrawal, the alcoholic is cold and nervous, as alcohol warms and relaxes. If a patient in the psychological field tries to suppress nervous tics for a while, these tics can be all the stronger afterwards. The psyche is used to the tics, it has established them as compensation for a problem, for example to relieve psychological pressure. If it is pulled out of this habitual attitude too briskly, the pressure cannot be compensated and the affected person reacts accordingly violently to get back into the habit. As another example, grief after the loss of a loved one is a kind of rebound, which is a missing of the habitual closeness of this person. Without the relationship with this person, there would have been no occasion for grief; the rebound symptoms of being alone are in some ways stronger than before the relationship.
