Fluoxetine-induced akathisia: clinical and theoretical implications.
Five patients receiving fluoxetine for the treatment of obsessive compulsive disorder or major depression developed akathisia. The typical fluoxetine-induced symptoms of restlessness, constant pacing, purposeless movements of the feet and legs, and marked anxiety were indistinguishable from those of neuroleptic-induced akathisia. Three patients who had experienced neuroleptic-induced akathisia in the past reported that the symptoms of fluoxetine-induced akathisia were identical, although somewhat milder. Akathisia appeared to be a common side effect of fluoxetine and generally responded well to treatment with the beta-adrenergic antagonist propranolol, dose reduction, or both. The authors suggest that fluoxetine-induced akathisia may be caused by serotonergically mediated inhibition of dopaminergic neurotransmission and that the pathophysiology of fluoxetine-induced akathisia and tricyclic antidepressant-induced "jitteriness" may be identical.
Lipinski
J F
JF
Laboratory for Psychiatric Research, McLean Hospital, Belmont, Mass 02178.
Mallya
G
G
Zimmerman
P
P
Pope
H G
HG
D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced; D003866:Depressive Disorder / Q000188:drug therapy*; D004298:Dopamine / Q000502:physiology; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D011595:Psychomotor Agitation / Q000503:physiopathology; D012701:Serotonin / Q000502:physiology; D009435:Synaptic Transmission / Q000187:drug effects
D005473:Fluoxetine; D012701:Serotonin; D004298:Dopamine