fluvoxamine and Dyskinesia--Drug-Induced

To review the case reports and case series of movement disorders ascribed to the use of serotonin selective reuptake inhibitors (SSRIs).. Reports of SSRI-induced extrapyramidal symptoms (EPS) in the literature were located using a MEDLINE search and review of bibliographies.. Among the 71 cases of SSRI-induced EPS reported in the literature, the most common side effect was akathisia (45.1%), followed by dystonia (28.2%), parkinsonism (14.1%), and tardive dyskinesia-like states (11.3%). Among patients with Parkinson's disease treated with SSRIs, there were 16 cases of worsening parkinsonism. Patients who developed dystonia, parkinsonism, or tardive dyskinesia were older on average than patients with akathisia; 67.6% of affected patients were females. Fluoxetine, the most commonly prescribed SSRI to date, was implicated in 53 (74.6%) of cases of SSRI-induced EPS. Several reports (57.7%) were confounded by the concomitant use of other medications that can contribute to the development of EPS.. SSRI-induced EPS are probably related to agonism of serotonergic input to dopaminergic pathways within the CNS. Several patient-dependent and pharmacokinetic variables may determine the likelihood that EPS will emerge. Although these side effects are infrequent, clinicians should be alert to the possibility of their occurrence.

Topics: 1-Naphthylamine; Adult; Age Factors; Aged; Akathisia, Drug-Induced; Depressive Disorder; Dyskinesia, Drug-Induced; Dystonia; Female; Fluoxetine; Fluvoxamine; Humans; Male; MEDLINE; Middle Aged; Parkinson Disease, Secondary; Paroxetine; Retrospective Studies; Selective Serotonin Reuptake Inhibitors; Sertraline; Sex Factors; United States

Topics: Depressive Disorder; Duloxetine Hydrochloride; Dyskinesia, Drug-Induced; Female; Fluvoxamine; Humans; Middle Aged; Selective Serotonin Reuptake Inhibitors; Thiophenes; Treatment Outcome

Topics: Adult; Anti-Bacterial Agents; Antidepressive Agents, Second-Generation; Clindamycin; Depressive Disorder; Drug Interactions; Dyskinesia, Drug-Induced; Fluvoxamine; Humans; Male

Topics: Aged; Depressive Disorder; Dyskinesia, Drug-Induced; Female; Fluvoxamine; Humans; Neurologic Examination; Selective Serotonin Reuptake Inhibitors

Topics: Adult; Depressive Disorder; Dyskinesia, Drug-Induced; Female; Fluvoxamine; Humans; Neurologic Examination; Tongue Habits

Topics: Aged; Basal Ganglia Diseases; Depressive Disorder; Dose-Response Relationship, Drug; Dyskinesia, Drug-Induced; Female; Fluvoxamine; Humans; Neurologic Examination