title: A case of dysgraphia induced by sertraline and a review of official spontaneous adverse reaction databases.
abstract: OBJECTIVE
  The occurrence of dysgraphia after sertraline intake has never been reported. The objective was to describe a case of this adverse drug reaction and present a review of similar cases held in international databases with a discussion of the possible pharmacological mechanisms.
  
  
  METHODS
  We observed a 60-year-old man who experienced resting tremors, dyskinesia and dysgraphia 2 months after a stepwise increase in sertraline dosing from 50 to 200 mg/day.
  
  
  CONCLUSIONS
  Dysgraphia is a possible adverse drug reaction to sertraline, and we suggest that inhibition of extrapyramidal dopaminergic activity might be the pharmacological mechanism.
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gentili
authors.affiliation: Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: P M
authors.initials: PM
authors.lastname: Marinaccio
authors.affiliation: Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Galimberti
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Carnovale
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.|Scientific Direction, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Antoniazzi
authors.affiliation: Scientific Institute, IRCCS E. Medea, Lecco, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Scientific Institute, IRCCS E. Medea, Lecco, Italy.|Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital 'Luigi Sacco', Università di Milano, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Clementi
authors.affiliation: Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Viganò
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Radice
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000381:Agraphia / Q000139:chemically induced*; D016208:Databases, Factual; D004298:Dopamine / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D020280:Sertraline / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D004298:Dopamine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline
keywords: adverse drug reaction; dysgraphia; pharmacovigilance; sertraline