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Extrapyramidal Reactions Associated with Serotonergic Antidepressants.

Jessica M Hawthorne1, Charles F Caley2

  • 1Providence VA Medical Center, Providence, RI, USA.

The Annals of Pharmacotherapy
|July 18, 2015
PubMed
Summary

Extrapyramidal reactions (EPRs) linked to serotonergic antidepressants are still being reported. Healthcare providers should monitor patients for these adverse drug reactions, as risk factors require further investigation.

Keywords:
akathisiaantidepressive agentsdyskinesiadystoniahumansparkinsonismserotonin reuptake inhibitors

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Area of Science:

  • Pharmacovigilance
  • Neuroscience
  • Clinical Pharmacology

Background:

  • Extrapyramidal reactions (EPRs) are known adverse effects of serotonergic antidepressants.
  • These reactions can cause patient distress and treatment non-adherence.

Purpose of the Study:

  • To conduct a follow-up review of published cases of EPRs associated with serotonergic antidepressants.
  • To analyze trends and characteristics of reported EPRs.

Main Methods:

  • A systematic literature search identified published EPR cases between January 1998 and May 2015.
  • Included cases of akathisia, dystonia, dyskinesia, parkinsonism, or mixed EPRs.
  • Naranjo scale assessed causality; data on patient demographics, diagnosis, dosage, and timing were extracted.

Main Results:

  • 86 reports involving 91 patients were identified; 80.2% implicated selective serotonin reuptake inhibitors.
  • All EPR types were observed, with dystonia and parkinsonism being most frequent.
  • EPRs typically occurred within 30 days of treatment initiation or dose increase; risk factors like age or gender were not broadly implicated.

Conclusions:

  • Published case reports of EPRs with serotonergic antidepressants persist.
  • Clinicians should remain vigilant in monitoring for EPRs.
  • Further research is necessary to elucidate clinical risk factors for these adverse drug reactions.