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Extrapyramidal syndrome, and interaction (first report) leading to hypomania: case report A 25-year-old woman with depressive disorder developed transient hypomania and extrapyramidal syndrome after switching from sertaline to dosulepin [routes, dosages and durations of treatment to reaction onset not stated]. Hypomanic symptoms were attributed to an interaction between sertraline and dosulepin, whereas the extrapyramidal syndrome was attributed to dosulepin as it continued beyond the drug-drug interaction period [outcomes not stated]. Agarwal A, et al. Dothiepin induced hypomania and extra-pyramidal syndrome: a case report. Indian Journal of Psychiatry 51: 143 abstr. P-10, Apr 2009. Available 801160705 from: URL: http://www.indianjpsychiatry.org - India

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Editorial comment: A search of AdisBase, Embase and Medline did not reveal any previous case reports of an interaction between dosulepin and sertraline. The WHO ADR database contained 24 reports associated with the concomitant use of dosulepin and sertraline.

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Reactions 16 Jul 2011 No. 1360