Akinetopsia from nefazodone toxicity

• Published in: American journal of ophthalmology Vol. 128; no. 4; pp. 530 - 531
• Main Authors: Horton, Jonathan C, Trobe, Jonathan D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-1999; Elsevier
• Subjects: Antidepressive Agents, Second-Generation - poisoning; Biological and medical sciences; Drug toxicity and drugs side effects treatment; Female; Humans; Male; Medical sciences; Middle Aged; Motion Perception - drug effects; Perceptual Disorders - chemically induced; Pharmacology. Drug treatments; Piperazines; Serotonin Antagonists - poisoning; Serotonin Uptake Inhibitors - poisoning; Toxicity: nervous system and muscle; Triazoles - poisoning; Human; Nervous system diseases; Serotonin; Toxicity; Nefazodone; Case study; Eye; Eye disease; Membrane receptor; Treatment; Antidepressant agent; Antagonist; Neurological disorder; Palinopsia
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(99)00177-4

PURPOSE: To investigate two cases of selective impairment of motion perception (akinetopsia) induced by toxicity from the antidepressant nefazodone, a new drug that blocks serotonin reuptake and antagonizes 5-HT
2 receptors.
METHODS: Case reports.
RESULTS: A 47-year-old man receiving nefazodone (Serzone; Bristol-Meyers Squibb, New York, N.Y.) (100 mg twice daily), reported a bizarre derangement of motion perception. Moving objects were followed by a trail of multiple “freeze-frame” images, which dissipated promptly when motion ceased. A 48-year-old woman receiving nefazodone (400 mg daily at bedtime) reported a similar phenomenon, with visual trails following moving objects. In both patients, vision returned to normal after the dosage of nefazodone was reduced or eliminated.
CONCLUSIONS: Nefazodone toxicity can result in akinetopsia, characterized by the inability to perceive motion in a normal, smooth fashion; persistence of multiple, strobelike images; and visual trails behind moving objects. In this rare syndrome, stationary elements are perceived normally, indicating that nefazodone causes selective impairment of pathways involved in motion processing in the visual system.