"Dopamine-dependent" side effects of selective serotonin reuptake inhibitors: a clinical review.
OBJECTIVE
Neurophysiologic findings indicate an inhibition of dopaminergic neurotransmission by selective serotonin reuptake inhibitors (SSRIs). This article highlights the relationships between changes in dopaminergic neurotrans-mission induced by SSRIs and the occurrence of certain side effects such as hyperprolactinemia, extrapyramidal symptoms, sexual and cognitive dysfunction, galactorrhea, mammary hypertrophy, and, more rarely, gynecomastia.


METHODS
A systematic search of the literature in English, French, and German from 1980 to 2004 was performed in MEDLINE, EMBASE, and the Cochrane Library using the keywords SSRI, dopamine, serotonin, side effects, antidepressants, citalopram, escitalopram, sertraline, paroxetine, fluoxetine, fluvoxamine, and nefazodone. References cited in all trials were searched iteratively to identify missing studies. All studies concerning inhibition of dopaminergic neurotransmission by SSRIs and SSRI-related side effects were considered. We retained 62 significant articles debating the subject.


METHODS
We critically reviewed the studies, depending on the methodologies (case reports, clinical reports, randomized studies), and assessed the pertinence of "dopamine-dependent" SSRI-related side effects. The analytic review of these articles suggests that some specific SSRI-related side effects be classified as dopamine-dependent.


CONCLUSIONS
At a clinical level, it could be useful to underline dopamine-dependent characteristics of some SSRI-related side effects. This approach would allow clinicians the opportunity to search other dopamine-dependent side effects systematically. At a pharmacologic level, this approach could stimulate the development of molecules with a "corrective" function on dopamine-dependent side effects of SSRIs by facilitating dopaminergic neurotransmission.
Department of Psychiatry, University of Geneva, Geneva, Switzerland. c.damsa@bluewin.ch
Cristian
C
Damsa
Anja
A
Bumb
Francesco
F
Bianchi-Demicheli
Pierre
P
Vidailhet
Robert
R
Sterck
Antonio
A
Andreoli
Stefan
S
Beyenburg
D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000503:physiopathology; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000139:chemically induced / Q000503:physiopathology; D003866:Depressive Disorder / Q000188:drug therapy; D004298:Dopamine / Q000502:physiology*; D005260:Female; D005687:Galactorrhea / Q000139:chemically induced / Q000503:physiopathology; D006177:Gynecomastia / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000503:physiopathology; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000503:physiopathology
D004298:Dopamine; D017367:Selective Serotonin Reuptake Inhibitors