Extrapyramidal Syndromes such as Oromandibular Dystonia, Akathisia, Parkinsonism as a Consequence of Paroxetine Use: A Case Report
Abstract
Selective serotonin
reuptake inhibitors (SSRI) are frequently used in the treatment of many
psychiatric disorders such as major depressive disorder, anxiety disorder, and
eating disorders. Side effects such as increased appetite, constipation, dry
mouth, sedation, restlessness, sweating and sexual dysfunction due to SSRI use
are frequently reported, while extrapyramidal syndromes (EPS) such as
akathisia, dystonia and parkinsonism are rarely seen. There are reports of
SSRIs such as fluoxetine, sertraline and fluvoxamine-induced EPS. We hereby
report a 37-year-old male case of EPS such as oromandibular dystonia,
akathisia, parkinsonism that developed after a chronic use of paroxetine 30
mg/day and its improvement with dose reduction. In this patient, paroxetine was
discontinued as dose-reduced paroxetine was not sufficient to treat anxiety
symptoms, and the use of escitalopram significantly reduced psychiatric
symptoms.
References
- 1. Madhusoodanan S, Alexeenko L, Sanders R, Brenner R. Extrapyramidal symptoms associated with antidepressants: a review of the literature and an analysis of spontaneous reports. Ann Clin Psychiatry 2010;22:148-56.
- 2. Arya DK. Extrapyramidal symptoms with selective serotonin reuptake inhibitors. Br J Psychiatry 1994;165(6):728-33.
- 3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; Author: Washington, DC, 2013.
- 4. Kose S, Akin E, Cetin M. Adverse drug reactions and causality: The Turkish version of Naranjo Adverse Drug Reactions Probability Scale. Psychiatry Clin Psychopharmacol 2017;27:205-6.
- 5. Örüm MH, Kara MZ, Eğilmez OB. Venlafaksin ve paroksetin kullanımına bağlı, orgazm olmaksızın idrar sonrasında ortaya çıkan spontan ejakülasyonlar: Bir olgu sunumu. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 2018;20(3):349-52.
- 6. Meltzer HY, Young M, Metz J, Fang VS, Schyve PM, Arora RC. Extrapyramidal side-effects and increased serum prolactin following fluoxetine, a new antidepressant. J Neural Transm 1979;45:165-75.
- 7. Edwards IR, Biriell C. Harmonisation in pharmacovigilance. Drug Saf 1994;10:93-102.
- 8. Ozen ME, Orum MH, Kalenderoglu A. Difficult patient in psychiatry practice: A case-control study. Adıyaman Üni Sağlık Bilimleri Derg 2018;4:1064-73.
Paroksetin Kullanımının Bir Sonucu Olarak Oromandibular Distoni, Akatizi, Parkinsonizm: Bir Olgu Sunumu
Abstract
Selektif serotonin geri
alım inhibitörleri (SSGİ) major depresif bozukluk, anksiyete bozukluğu, yeme
bozuklukları gibi birçok psikiyatrik hastalığın tedavisinde sıklıkla kullanılmaktadır.
SSRI kullanımına bağlı iştah artışı, kabızlık, ağız kuruluğu, sedasyon,
huzursuzluk, terleme, cinsel işlev bozukluğu gibi yan etkiler sıklıkla
bildirilirken akatizi, distoni, parkinsonizm gibi extapiramidal sendromlar (EPS)
nadiren görülmektedir. Fluoksetin, sertralin ve fluvoksamin gibi SSGİ’lere
bağlı EPS bildirimleri bulunmaktadır. Burada, uzun süredir paroksetin 30 mg/gün
kullanan 37 yaşındaki erkek hastada ortaya çıkan oromandibular distoni,
akatizi, parkinsonism gibi EPS yan etkilerinin doz azaltımı ile iyileşmesini
sunduk. Bu hastada dozu azaltılmış paroksetin anksiyete semptomlarını tedavi
etmeye yeterli olmadığı için paroksetin kesildi ve essitalopram kullanımı ile psikiyatrik
semptomlar belirgin olarak azaltıldı.
References
- 1. Madhusoodanan S, Alexeenko L, Sanders R, Brenner R. Extrapyramidal symptoms associated with antidepressants: a review of the literature and an analysis of spontaneous reports. Ann Clin Psychiatry 2010;22:148-56.
- 2. Arya DK. Extrapyramidal symptoms with selective serotonin reuptake inhibitors. Br J Psychiatry 1994;165(6):728-33.
- 3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; Author: Washington, DC, 2013.
- 4. Kose S, Akin E, Cetin M. Adverse drug reactions and causality: The Turkish version of Naranjo Adverse Drug Reactions Probability Scale. Psychiatry Clin Psychopharmacol 2017;27:205-6.
- 5. Örüm MH, Kara MZ, Eğilmez OB. Venlafaksin ve paroksetin kullanımına bağlı, orgazm olmaksızın idrar sonrasında ortaya çıkan spontan ejakülasyonlar: Bir olgu sunumu. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 2018;20(3):349-52.
- 6. Meltzer HY, Young M, Metz J, Fang VS, Schyve PM, Arora RC. Extrapyramidal side-effects and increased serum prolactin following fluoxetine, a new antidepressant. J Neural Transm 1979;45:165-75.
- 7. Edwards IR, Biriell C. Harmonisation in pharmacovigilance. Drug Saf 1994;10:93-102.
- 8. Ozen ME, Orum MH, Kalenderoglu A. Difficult patient in psychiatry practice: A case-control study. Adıyaman Üni Sağlık Bilimleri Derg 2018;4:1064-73.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | December 1, 2019 |
| Acceptance Date | September 30, 2019 |
| Published in Issue | Year 2019 Volume: 1 Issue: 2 |
Chief Editors
Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye
Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye
E-mail: medrecsjournal@gmail.com
Publisher:
Medical Records Association (Tıbbi Kayıtlar Derneği)
Address: Düzce / Türkiye
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