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Movement disorders associated with the serotonin selective reuptake inhibitors
1Department of Psychiatry, School of Medicine, State University of New York at Buffalo 14215, USA.
The Journal of Clinical Psychiatry
|October 1, 1996
Summary
Serotonin selective reuptake inhibitors (SSRIs) can cause movement disorders like akathisia and dystonia. Clinicians should monitor patients for these extrapyramidal symptoms (EPS), especially when using fluoxetine.
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Medicine
Background:
- Movement disorders have been linked to the use of serotonin selective reuptake inhibitors (SSRIs).
- A review of existing literature was conducted to examine these cases.
Purpose of the Study:
- To review case reports and series of movement disorders associated with SSRI use.
- To identify the types and frequency of extrapyramidal symptoms (EPS) induced by SSRIs.
Main Methods:
- A MEDLINE search was performed to identify reports of SSRI-induced EPS.
- Bibliographies of relevant articles were reviewed to gather additional case data.
Main Results:
- Of 71 reported cases, akathisia was most common (45.1%), followed by dystonia (28.2%), parkinsonism (14.1%), and tardive dyskinesia-like states (11.3%).
- Fluoxetine was implicated in 74.6% of cases. Patients developing dystonia, parkinsonism, or tardive dyskinesia were older and predominantly female.
- 16 cases of worsening parkinsonism occurred in patients with pre-existing Parkinson's disease treated with SSRIs.
Conclusions:
- SSRI-induced EPS are likely due to serotonergic agonism affecting dopaminergic pathways.
- Patient-specific and pharmacokinetic factors may influence EPS development.
- While infrequent, clinicians must remain vigilant for potential SSRI-induced EPS.