Document Detail


Extrapyramidal symptoms associated with antidepressants--a review of the literature and an analysis of spontaneous reports.
MedLine Citation:
PMID:  20680187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Antidepressant-induced extrapyramidal symptoms (EPS) represent an underrecognized but important clinical entity. We reviewed the literature on new antidepressants and conducted an analysis of cases from the FDA Adverse Event Reporting System (AERS), which has not been published before.
METHODS: A literature review was conducted using PubMed, Ovid, MEDLINE, PsycINFO, and the Cochrane Database. Search terms used were extrapyramidal, antidepressants, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), norepinephrine-dopamine reuptake inhibitors (NDRIs), miscellaneous antidepressants, and monoamine oxidase inhibitors (MAOIs). Inclusion criteria for the FDA AERS analysis were cases of EPS reported by physicians, cases where patients were on one antidepressant, and cases reported between July 2005 and March 2008. Reports of patients who were on concurrent psychotropics were excluded.
RESULTS: Our literature review revealed 1 report each of EPS for duloxetine, nefazodone, and bupropion, 3 for escitalopram, and 4 for citalopram. For the FDA AERS analysis, 89 cases met our inclusion criteria: duloxetine was implicated in 66% of cases, sertraline in 10%, escitalopram in 7%, and bupropion in 6%.
CONCLUSIONS: EPS have been reported with different classes of antidepressants, are not dose related, and can develop with short-term or long-term use. In view of the risk for significant morbidity and decreased quality of life, clinicians must be aware of the potential for any class of antidepressants to cause these adverse effects.
Authors:
Subramoniam Madhusoodanan; Lada Alexeenko; Renata Sanders; Ronald Brenner
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists     Volume:  22     ISSN:  1547-3325     ISO Abbreviation:  Ann Clin Psychiatry     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911021     Medline TA:  Ann Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  148-56     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, St. John's Episcopal Hospital, Far Rockaway, NY 11691, USA. sdanan@ehs.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic Uptake Inhibitors / adverse effects,  therapeutic use
Adult
Adverse Drug Reaction Reporting Systems
Aged
Aged, 80 and over
Akathisia, Drug-Induced / diagnosis
Antidepressive Agents / adverse effects*,  therapeutic use
Antidepressive Agents, Tricyclic / adverse effects,  therapeutic use
Basal Ganglia Diseases / chemically induced*,  diagnosis
Cross-Sectional Studies
Depressive Disorder / drug therapy*
Dose-Response Relationship, Drug
Drug Administration Schedule
Dyskinesia, Drug-Induced / diagnosis
Dystonia / chemically induced,  diagnosis
Female
Humans
Male
Middle Aged
Monoamine Oxidase Inhibitors / adverse effects,  therapeutic use
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
United States
United States Food and Drug Administration
Young Adult
Chemical
Reg. No./Substance:
0/Adrenergic Uptake Inhibitors; 0/Antidepressive Agents; 0/Antidepressive Agents, Tricyclic; 0/Monoamine Oxidase Inhibitors; 0/Serotonin Uptake Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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