[A case of rare side effects of certain antidepressive drugs]

Because of a depressive syndrome, a 39-year-old patient received 20 mg fluoxetine per day. Approximately 4 weeks later, treatment with this drug was stopped after the patient had complained of worsening tremor, particularly of the upper extremities. In addition, accommodation difficulties and problems with word-finding had appeared shortly before. The symptoms became worse after fluoxetine had been discontinued. Treatment of the side effects with piperiden and bromazepam brought about no real improvement in the patient's condition. The passive tremor with a frequency of approximately eight per second mainly suggests an extrapyramidal-parkinsonian cause. Five weeks after treatment with fluoxetine had been discontinued, owing to the persistence of the depressive syndrome the patient received maprotiline and clomipramine by infusion in a private hospital. After 2-3 days the patient complained of headaches and had a slightly raised temperature. After 7 days maprotiline and clomipramine were discontinued completely. During the fever there was no leucocytosis, so that a drug fever was diagnosed. These rare side effects are discussed.