Emergency Department Presentation of Duloxetine-induced Acute Extrapyramidal Symptoms: A Case Report

Duloxetine, a serotonin-norepinephrine reuptake inhibitor, has been associated with extrapyramidal symptoms and tardive syndromes; however, such adverse reactions are rare and remain sparsely documented, particularly in the setting of non-psychiatric use.

A young, healthy, active-duty military service member developed acute extrapyramidal symptoms-restlessness, dystonic movements, and acute dystonia-shortly after initiating duloxetine for postsurgical neuropathic pain.

This case highlights the need for vigilance regarding movement disorders in patients prescribed duloxetine, even in the absence of psychiatric comorbidity or antipsychotic exposure.