Eastern Journal of Psychiatry

Register      Login

VOLUME 14 , ISSUE 1-2 ( February-August, 2011 ) > List of Articles


Acute Dystonia with Paroxetine – Case Presentation, Possible Mechanism and Clinical Implications

Kaustav Chakraborty

Citation Information : Chakraborty K. Acute Dystonia with Paroxetine – Case Presentation, Possible Mechanism and Clinical Implications. 2011; 14 (1-2):48-49.

DOI: 10.5005/EJP-14-1--2-48

License: CC BY-NC 4.0

Published Online: 13-10-2021

Copyright Statement:  Copyright © 2011; The Author(s).


Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that is used in the treatment of panic disorder. SSRIs as a group are known to causeextra-pyramidal syndrome (EPS) even at therapeutic doses. However, systematic data regarding this is lacking. We describe a case of acute cervical dystonia in a young adult with panic disorder temporally related to paroxetine. The dystonia was relieved by intravenous injection of promethazine, an antihistaminic with anticholinergic property. Inhibitory serotonergic input to dopaminergic system in the nigro-striatal pathway may be responsible for such idiosyncratic reaction. Clinicians should be aware of such side effect while prescribing SSRIs as this can have significant clinical implications

PDF Share
  1. Paroxetine product monograph (Paxil, SmithKline Beecham— Canada), Rev 11/6/95, Rec 11/96
  2. Stahl SM. In: Stahl SM, editor. Essential Psychopharmacology. 2nd ed. United States of America: Cambridge University Press; 2000. p. 199-244
  3. Schillevoort I, van Puijenbroek EP, de Boer A, Roos RAC, Jansen PAF, Leufkens HGF. Extrapyramidal syndromes associated with selective serotonin reuptake inhibitors: a casecontrol study using spontaneous reports. Int Clin Psychopharmacology 2002; 17:75-79
  4. Damsa C, Bumb A, Bianchi-Demicheli F, Vidailhet P, Sterck R, Andreoli A, et al. “Dopamine-dependent” side effects of selective serotonin reuptake inhibitors: a clinical review. J Clin Psychiatry 2004; 65: 1064-1068
  5. Leo RJ. Movement disorders associated with the serotonin selective reuptake inhibitors. J Clin Psychiatry 1996; 57: 449–454
  6. Arnone D, Hansen L, Kerr JS. Acute dystonic reaction in an elderly patient with mood disorder after titration of paroxetine: possible mechanisms and implications for clinical care. J Psychopharmacol 2002; 16: 395-397
  7. Hansen L. A critical review of akathisia and its possible association with suicidal behaviour. Hum Psychopharmacol 2001; 16: 495-505
  8. Dray A. Serotonin in the basal ganglia: functions and interactions with other neuronal pathways. J Physiol (Paris) 1981; 77: 393-403
  9. Fibiger HC, Lloyd KG. Neurobiological substrates of tardive dyskinesia: the GABA hypothesis. Trends Neurosci 1984; 7: 462-464
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.