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Sertraline/venlafaxine Cervical torticollis and psychogenic movement disorder: case report A 29-year-old woman being treated for sadness and anxiety developed cervical torticollis and psychogenic movement disorder while receiving venlafaxine and sertraline, respectively. The woman presented to the emergency room (ER) 2 hours after receiving 75mg of venlafaxine with wave-like movements of the tongue and cervical torsion. The movements subsided after a single 5mg dose of biperiden. The woman’s symptoms recurred three times in the following week and were again treated with biperiden. She was asymptomatic for 1 year. At that time she was prescribed 50mg of sertraline for depressive symptoms. Two hours after the first intake she presented to the ER with an exuberant, arrhythmic, large-amplitude and long-lasting chin tremor. She was diagnosed with psychogenic tremor and a psychiatric evaluation revealed a conversion disorder. At last follow-up, she was currently not receiving medication and the frequency of chin tremors has lessened. Author comment: "In the first episode, the movement disorder phenomenology, its clear-cut relation to drug administration, and its prompt response to anticholinergic medication is strongly suggestive of venlafaxine-induced dystonia. . . In contrast, several features led us to label the second movement disorder as psychogenic." Fonseca L, et al. Psychogenic movement disorder after a venlafaxine-induced dystonia. Movement Disorders 25: 506-507, No. 4, 15 Mar 2010. Available from: 803013741 URL: http://dx.doi.org/10.1002/mds.22910 - Portugal

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Reactions 29 May 2010 No. 1303