Cetirizine
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Cetirizine Involuntary movements: case report A 24-year-old woman developed involuntary movements associated with cetirizine use. The woman presented to a hospital emergency department (ED) following an accident after acute alcohol intoxication. She reported receiving cetirizine 10 mg/day for 3 months [route and therapeutic indication not stated]. During her stay in the ED, she developed acute involuntary grimacing movements and dysarthria. The woman was treated with diphenhydramine, benzatropine and lorazepam, and her dystonia rapidly resolved. At follow-up a month later, she admitted discontinuing cetirizine after her discharge from the ED. On the day after her discharge, she had developed facial twitching, and she had experienced two episodes of difficulty walking, hand "discoordination" and "muscle jerks of her throat" lasting approximately 20 minutes during this month. She was offered an outpatient neurology consultation, however, there was no further information available in relation to the appointment [outcome not stated]. Author comment: "We speculate that . . . cetirizine blocked the striatal D2 receptors and resulted in an acute dystonic reaction in our patient. In addition, we also speculate that our patient’s 3-month cetirizine use resulted in D2 receptor hypersensitivity similar to that observed in longterm antipsychotic use, with subsequent involuntary movements after its discontinuation." Romo CA, et al. Involuntary movements associated with cetirizine use. American Journal of Psychiatry 168: 855, No. 8, Aug 2011. Available from: URL: http:// 803062496 dx.doi.org/10.1176/appi.ajp.2011.11040534 - USA
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Reactions 12 Nov 2011 No. 1377
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