Escitalopram
- PDF / 170,809 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 68 Downloads / 178 Views
1 S
Tardive dyskinesia: case report A 22-year-old man developed tardive dyskinesia (TD) during treatment with escitalopram for major depressive disorder. The man had a history of attention-deficit/hyperactive disorder and major depressive disorder. He was treatment-naive for selective serotonin reuptake inhibitors (SSRIs) and did not receive any medication for attention-deficit/hyperactive disorder. As a result of diastolic heart failure, congestive hepatopathy and aortic stenosis, he underwent liver and cardiac transplantation. Two months after the transplant, he started receiving escitalopram 5mg [route and dose frequency not stated] for low mood, anxiety and frustration. He had well-tolerated escitalopram treatment with no adverse effects. At the neurologic examination, a mild tremor was observed. After 4 weeks of escitalopram treatment, his escitalopram dose was increased to 7.5mg to optimize benefits. Concomitantly, he had received trazodone for insomnia symptoms. After 5 weeks of escitalopram initiation, the escitalopram dose further increased to 10mg daily. He tolerated escitalopram 10mg for 3 weeks (4 months after transplant), he was discharged from hospital with aspirin, atorvastatin, colecalciferol [vitamin D3], cetirizine, diltiazem, famotidine, oxycodone, gabapentin, mycophenolate, prednisone, sildenafil, cotrimoxazole [sulfamethoxazole-trimethoprim], tacrolimus, valganciclovir, salbutamol [albuterol], zolpidem, melatonin, furosemide and spironolactone. One week after discharge, he developed episodes of leg and arm tremors, along with and difficulty speaking and stiffness. At neurology, orofacial dyskinesias with mixed hyperkinetic movements of extremities involving primarily of myoclonus with mild generalised dystonia/ chorea and bilateral hand tremors. Repeat brain MRI was non-significant. Afterwards (5 months post-transplant), he was returned to the neurology clinic, and based on presentation, escitalopram-mediated TD was diagnosed. His abnormal involuntary movement scale (AIMS) score was 10 after 6 months posttransplant. Therefore, the man’s treatment with escitalopram was tapered and stopped over 1 week. Two weeks later (on psychiatry followup), his motor symptoms improved (AIMS score 5). He has only subtle athetoid, bilateral upper extremity movements and lip dyskinesia was observed. At 7 months after the transplant, he had a modest improvement in symptoms. At 9 months posttransplant, his occasional lateral jaw movements and TD symptoms improved. At the recent follow-up (14 months post-transplant), he had complete resolution of symptoms, except for subtle involuntary hand movements like handwriting. Fischer A, et al. Selective Serotonin Reuptake Inhibitors and Tardive Dyskinesia: A Case Report of Escitalopram Use in a Cardiac and Liver Transplant Patient. Journal of 803518530 Clinical Psychopharmacology 40: 626-627, No. 6, Nov 2020. Available from: URL: http://doi.org/10.1097/JCP.0000000000001285
0114-9954/20/1833-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
React
Data Loading...
