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Comment in:
·
J
Clin Psychiatry. 1990 May;51(5):210-2.
·
J
Clin Psychiatry. 1990 May;51(5):212.
Fluoxetine-induced akathisia: clinical and theoretical
implications.
Lipinski JF Jr, Mallya G, Zimmerman P, Pope
HG Jr.
Laboratory for Psychiatric Research, McLean Hospital, Belmont,
Mass 02178.
Five patients receiving fluoxetine for the treatment of
obsessive compulsive disorder or major depression developed akathisia. The
typical fluoxetine-induced symptoms of restlessness, constant pacing,
purposeless movements of the feet and legs, and marked anxiety were
indistinguishable from those of neuroleptic-induced akathisia. Three patients
who had experienced neuroleptic-induced akathisia in the past reported that the
symptoms of fluoxetine-induced akathisia were identical, although somewhat
milder. Akathisia appeared to be a common side effect of fluoxetine and
generally responded well to treatment with the beta-adrenergic antagonist
propranolol, dose reduction, or both. The authors suggest that
fluoxetine-induced akathisia may be caused by serotonergically mediated
inhibition of dopaminergic neurotransmission and that the pathophysiology of
fluoxetine-induced akathisia and tricyclic antidepressant-induced "jitteriness"
may be identical.
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