Acute Dystonia due to Citalopram Treatment: A Case Series

S Mohammad Moosavi,Mahshid Ahmadi,Mani B Monajemi

doi:10.5539/gjhs.v6n6p295

Abstract

Introduction:Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of Parkinson disease, akathisia and possibly neuroleptic malignant syndrome may be associated with the use of selective serotonin reuptake inhibitors (SSRIs) rarely. Citalopram, a typical SSRI, used in serotonergic dysfunction related disorders, potentially can cause extrapyramidal symptoms such as acute dystonia.Methods:In a retrospective survey on patients referred to psychiatric clinic between February 2010 and February 2011 who were prescribed citalopram by the psychiatrist. The data about Demographic, history of drug and alcohol abuse or dependence, diagnosis and citalopram consumption length collected. The daily dose of citalopram was also recorded. Acute dystonia was identified by a validated chart review and precise neurological examination.Results:Nine patients were included. Citalopram was initiated at a 20 mg and titrated to a mean dose of 27 mg. The median length of acute dystonia after citalopram therapy was nine days. Other common adverse events included somnolence, gastric upset and nightmare in the cases.Conclusions:This case series was an effort to show the citalopram potential to trigger acute dystonia. Clinician needs to be aware of possible dystonia, as early recognition is necessary to prevent major adverse outcomes.

Highlights

Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of Parkinson disease, akathisia and possibly neuroleptic malignant syndrome may be associated with the use of selective serotonin reuptake inhibitors (SSRIs) rarely
Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of parkinson disease, akathisia and possibly neuroleptic malignant syndrome may associated with the use of SSRIs very rarely
This review was unfunded and we reviewed the case files from February 2010 to February 2011 who were under citalopram treatment by the psychiatrist for variety of depressive disorder and anxiety disorders (Obsessive-compulsive disorder, General anxiety disorder, Panic disorder and Posttraumatic stress disorder)

Summary

Introduction

Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of Parkinson disease, akathisia and possibly neuroleptic malignant syndrome may be associated with the use of selective serotonin reuptake inhibitors (SSRIs) rarely. Citalopram, a typical SSRI, used in serotonergic dysfunction related disorders, potentially can cause extrapyramidal symptoms such as acute dystonia. Antidepressant induced extrapyramidal symptoms (EPS) represent an under recognized but important clinical entity. These symptoms reported for duloxetine, nefazodone, bupropione and citalopram. Tremor is considered as a second most common neurological adverse effect of SSRIs based on literatures Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of parkinson disease, akathisia and possibly neuroleptic malignant syndrome may associated with the use of SSRIs very rarely. In view of the risk of morbidity and decreased quality of life and/or even mortality in case of laryngospasm due to contraction of laryngeal muscles contraction laryngeal dystonia is a life-threatening side-effect of and its diagnosis often remains elusive (Christodoulou & Kalaitzi, 2005) and to aware the clinicians of potential to cause adverse effects; we reported the nine cases developed acute dystonia www.ccsenet.org/gjhs

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