Am J Psychiatry 1995; 152:122-125
Copyright © 1995 by American Psychiatric Association
Fluoxetine and extrapyramidal side effects
DM Coulter and PI Pillans
University of Otago Medical School, Dunedin, New Zealand.
OBJECTIVE: The authors' goal was to determine whether fluoxetine is
associated with extrapyramidal side effects. METHOD: They assessed the
notifications of extrapyramidal manifestations in patients given fluoxetine
in the New Zealand Intensive Medicines Monitoring Programme, a national
system that monitored adverse reactions associated with fluoxetine over a
4-year period, and determined whether these adverse reactions were causally
related to fluoxetine. RESULTS: In reports of adverse reactions in 5,555
patients given fluoxetine throughout New Zealand, there were 15
notifications of extrapyramidal events probably or possibly caused by
fluoxetine. Fluoxetine was the only psychotropic agent used for seven of
the 15 patients; two patients were also taking lithium, four were taking
neuroleptics, two were taking tricyclic antidepressants, and one was taking
metoclopramide. CONCLUSIONS: The authors conclude that fluoxetine may be
associated with extrapyramidal reactions. These may occur with fluoxetine
alone or fluoxetine may facilitate the reaction in patients receiving
psychotropic medication or dopamine receptor blocking drugs.
