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Antidepressant exacerbation of spasticity
K A Stolp-Smith1, M C Wainberg
1Department of Physical Medicine and Rehabilitation, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Archives of Physical Medicine and Rehabilitation
|March 20, 1999
Summary
Selective serotonin reuptake inhibitors may worsen spasticity in spinal cord injury (SCI) patients. This finding is crucial for managing depression in individuals with SCI and spasticity.
Area of Science:
- Neuroscience
- Pharmacology
- Rehabilitation Medicine
Background:
- Spinal cord injury (SCI) frequently leads to depression, complicated by factors like spasticity.
- Treating depression in SCI patients is challenging due to altered neurochemistry and receptors.
- Newer antidepressants selectively target serotonergic neurotransmission.
Observation:
- A case report details the exacerbation of spasticity in SCI patients using specific antidepressant medications.
- This exacerbation highlights a potential adverse effect of serotonergic antidepressants in this population.
Findings:
- Selective serotonin reuptake inhibitors (SSRIs) may increase spasticity in individuals with spinal cord injury.
- Potential mechanisms include serotonin's effect on motor neurons, denervation supersensitivity, and serotonin syndrome.
Implications:
- Clinicians should consider the risk of increased spasticity when prescribing SSRIs to SCI patients.
- Understanding the interplay between serotonergic systems and spasticity is vital for effective depression management in SCI.
- Further research is needed to elucidate the precise mechanisms and guide treatment strategies.