fluvoxamine and Movement-Disorders

Central pontine and extrapontine myelinolysis (CPEM) are rare conditions usually associated with rapid correction of hyponatremia. Neurologic complications are the usual sequelae although neuropsychiatric features are rare. Described herein are unusual psychotic symptoms following CPEM and discussion of the likely pathogenesis and implications for treatment.

Topics: Antidepressive Agents, Second-Generation; Antiparkinson Agents; Antipsychotic Agents; Baclofen; Female; Fluvoxamine; GABA Agonists; Humans; Magnetic Resonance Imaging; Middle Aged; Movement Disorders; Myelinolysis, Central Pontine; Psychotic Disorders; Quadriplegia; Risperidone; Trihexyphenidyl

Though 5-HT plays an important role in the modulation of motor function, which is perturbed in depressive states, little is known concerning the influence of serotonin reuptake inhibitors (SSRIs) on locomotor activity (LA). Recently, we demonstrated that SSRIs, such as citalopram, enhance LA in mice exposed to a novel environment.. This study examined the role of multiple classes of 5-HT receptor in citalopram-induced LA.. The most selective antagonists currently available were used.. Citalopram-induced LA was dose-dependently attenuated by the 5-HT1B/1D receptor antagonists, S18127, GR125,743 and GR127,935, and by the selective 5-HT1B antagonist, SB224,289, but unaffected by the selective 5-HT1A antagonist, WAY100,635. The selective antagonists at 5-HT2A receptors, MDL100,907 and SR46,349 also dose-dependently attenuated induction of locomotion by citalopram, whereas the 5-HT2B antagonist, SB204,741, and the 5-HT2B/2C antagonist, SB206,553 were ineffective. Further, the selective 5-HT2C antagonist, SB242,084, potentiated the response to citalopram. Selective antagonists at 5-HT3 (ondansetron), 5-HT4 (GR125,487), 5-HT6 (SB271,046) and 5-HT7 (SB269,970) receptors did not significantly modify the action of citalopram. Underpinning these findings, SB224,289, GR125,743, MDL100,907 and SR46,349 likewise attenuated induction of locomotion by a further SSRI, fluvoxamine.. The locomotor response to SSRIs of mice exposed to a novel environment is mediated via 5-HT1B and 5-HT2A receptors. In view of the importance of motor function to the etiology and treatment of depression, the significance of these observations to the clinical actions of SSRIs will be of interest to elucidate.

Topics: Animals; Citalopram; Environment Design; Fluvoxamine; Injections, Subcutaneous; Male; Mice; Motor Activity; Movement Disorders; Receptor, Serotonin, 5-HT1B; Receptor, Serotonin, 5-HT2B; Receptors, Serotonin; Selective Serotonin Reuptake Inhibitors; Serotonin 5-HT1 Receptor Antagonists; Serotonin 5-HT2 Receptor Antagonists

Topics: Fluvoxamine; Humans; Male; Middle Aged; Movement Disorders; Muscle Rigidity; Oximes; Serotonin Antagonists