Torticollis under cyclobenzaprine.
The muscle-relaxing 5-HT(2) receptor antagonist cyclobenzaprine is structurally closely related to amitriptyline. It is widely used to treat patients presenting with back pain and fibromyalgia. Very rarely cyclobenzaprine toxicity can result in extrapyramidal symptoms, but occurrence of torticollis has not been reported so far. We report on a patient presenting with torticollis and myoclonic movements after treatment with cyclobenzaprine, who was successfully treated with intravenous biperiden. This case might be additional evidence for the necessity of appropriate dosage in case of liver impairment. Secondly there are possibly consequences as regards the therapy of motor side effects.
Reuss
Reinhard
R
Department of Neurology, Justus Liebig University Giessen, Giessen, Germany. Reinhard.Reuss@neuro.med.uni-giessen.de
Reuter
Iris
I
Jauss
Marek
M
Fischer
Falko
F
Muller
Silke C
SC
Stolz
Erwin
E
D000639:Amitriptyline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001712:Biperiden / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009125:Muscle Relaxants, Central / Q000009:adverse effects* / Q000627:therapeutic use; D009207:Myoclonus / Q000139:chemically induced / Q000188:drug therapy; D014103:Torticollis / Q000139:chemically induced* / Q000188:drug therapy; D055815:Young Adult
D018727:Muscarinic Antagonists; D009125:Muscle Relaxants, Central; D001712:Biperiden; D000639:Amitriptyline; C004704:cyclobenzaprine