Extrapyramidal syndromes associated with selective serotonin reuptake inhibitors: a case–control study using spontaneous reports

• Published in: International clinical psychopharmacology Vol. 17; no. 2; pp. 75 - 79
• Main Authors: Schillevoort, I, van Puijenbroek, E.P, de Boer, A, Roos, R.A.C, Jansen, Paul A.F, Leufkens, H.G.M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-03-2002; Lippincott Williams & Wilkins
• Subjects: Aged; Antidepressive Agents - adverse effects; Basal Ganglia Diseases - chemically induced; Basal Ganglia Diseases - epidemiology; Biological and medical sciences; Case-Control Studies; Databases, Factual; Drug toxicity and drugs side effects treatment; Female; Humans; Male; Medical sciences; Middle Aged; Netherlands; Pharmacology. Drug treatments; Product Surveillance, Postmarketing; Restless Legs Syndrome - chemically induced; Restless Legs Syndrome - epidemiology; Risk Assessment; Serotonin Uptake Inhibitors - adverse effects; Toxicity: nervous system and muscle; Netherlands; Human; Mood disorder; Nervous system diseases; Drug combination; Serotonin; Neuroleptic; Psychotropic; Toxicity; Reuptake inhibitor; Long term; Cerebral disorder; Chemotherapy; Treatment; Central nervous system disease; Antidepressant agent; Drug interaction; Extrapyramidal syndrome
• ISSN: 0268-1315; 1473-5857
• DOI: 10.1097/00004850-200203000-00006

The aim of this study was to assess whether use of selective serotonin reuptake inhibitors (SSRIs) is associated with extrapyramidal syndromes (EPS). We analysed the spontaneous reports of adverse drug reactions (ADRs) collected by The Netherlands Pharmacovigilance Foundation Lareb in the period 1985–99 (n =24 263). The study population comprised all patients using an antidepressant drug at the time the ADR occurred. We calculated ADR-reporting odds ratios (ADR-OR) to estimate the association between SSRI-use and EPS, relative to other antidepressants. We identified 61 patients with EPS. SSRI-use was associated with spontaneous reporting of EPS compared to other antidepressants (adjusted ADR-OR 2.2; 95% confidence interval 1.2–3.9). This risk estimate appeared to be higher in patients concurrently using antipsychotic medication (6.9, 0.7–68.0), although the confidence interval was very wide. In conclusion, SSRI-use seems only to be moderately associated with EPS compared to other antidepressants. However, those concurrently using antipsychotic drugs or presenting with other risk factors may be more susceptible and should be closely monitored.