Orofacial dyskinesia: caused by antidepressants?

A case report is presented of a 72 year old woman, who has been treated for a depression with amitriptyline. During the treatment an orofacial dyskinesia develloped. Data in the literature concerning a possible link between the manifestation of orofacial dyskinesia and treatment with antidepressants were mainly found to be case reports. A closer study of the total in all of 25 case reports reveals that the antidepressant is often at most one of more possible determinants of the movement disorder. Particularly, it was frequently noted that patients were treated with other drugs or that the use of other drugs was not specified. A controverse exists in the literature whether or not a so called spontaneous orofacial dyskinesia is found in high frequency in elderly people. For clinical practice the advice is given that, in case an orofacial dyskinesia arises during antidepressant treatment, attention should be paid to other provoking factors in the first place.