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Báo cáo y học: "Extrapyramidal side effects and suicidal ideation under fluoxetine treatment: a case repot"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Extrapyramidal side effects and suicidal ideation under fluoxetine treatment: a case report. | Christodoulou et al. Annals of General Psychiatry 2010 9 5 http www.annals-general-psychiatry.eom content 9 1 5 ANNALS OF GENERAL PSYCHIATRY CASE REPORT Open Access Extrapyramidal side effects and suicidal ideation under fluoxetine treatment a case report Christos Christodoulou 1 Athanasia Papadopoulou1 Emmanouil Rizos1 Kalliopi Tournikioti1 Xenia Gonda2 Athanassios Douzenis1 Lefteris Lykouras1 Abstract Background We present the case of a 52-year-old woman with depression who developed extrapyramidal symptoms mainly parkinsonism and suicidal ideation while on fluoxetine. Methods The patient underwent neurological and neuroimaging examination. Results The patient s neurological and neuroimaging examinations were normal and there was no other cause of extrapyramidal symptoms. The patient showed remission of the aforementioned symptomatology when fluoxetine was discontinued. Conclusions This case shows that fluoxetine can be associated with extrapyramidal symptoms and this may have an aggravating affect on clinical depression progress and the emergence of suicidal ideation. Background Extrapyramidal symptoms EPSs are an uncommon side effect of serotonin reuptake inhibitors SSRIs . Concomitant use with antipsychotic medication or the presence of other risk factors age gender increase the vulnerability to EPSs 1 . The most common EPS associated with SSRIs seems to be akathisia followed by dystonia and parkinsonism. Fluoxetine is the SSRI most associated with extrapyramidal reactions in the majority of cases 2 3 . Even in adolescents treated with fluoxetine EPSs have been reported 4 . The symptoms are reversible with dose reduction drug discontinuation or by the addition of another agent such as anticholinergic agents b-blockers or benzodiazepines 5 6 . EPSs and especially akathisia have been associated with the emergence of suicidal ideation and suicidal acts in patients receiving fluoxetine 7 8 however a clear relationship between fluoxetine and emerging suicidality is