Benefical Effects of Sigma-1 Agonist Fluvoxamine for Tardive Dyskinesia and Tardive Akathisia in Patients with Schizophrenia: Report of Three Cases

Abstract

Fluvoxamine is a selective serotonin reuptake inhibitor that is approved for psychiatric disorders such as major depressive episodes and obsessive-compulsive disorder. Beside inhibition of serotonin reuptake, fluvoxamine is also a potent agonist of endoplasmic reticulum (ER) protein sigma-1 receptors, which play a role in the pathophysiology of a number of psychiatric and neurodegenerative disorders. This report presents beneficial effects of sigma-1 agonist fluvoxamine on hyperkinetic movement disorders such as tardive dyskinesia and tardive akathisia. Fluvoxamine might be a novel treatmet approach in the treatment of hyperkinetic movement disorders.

A Report of Rabbit Syndrome Who Benefited from Sigma 1 Agonist Fluvoxamine

“…They firstly concluded that the action mechanism of fluvoxamine for resolving akathisia might be associated with sigma 1 receptor agonism. We have also reported cases who benefited from fluvoxamine in terms of; hemiballism and depressive disorder27); tardive dyskinesia in patients with post-psychotic depressive disorder of schizophrenia28); duloxetine induced tardive dyskinesia29); tardive dyskinesia in two patients with schizophrenia30); tardive akathisia in a patient with schizophrenia30); and improvement of chorea 31). There are conflicting data on the activity of sigma 1 receptors on the dopaminergic system.…”

Risperidone-induced tardive akathisia: A rare antipsychotic side effect with management issues

“…),[56] no reports of TA ascribed to nonneuroleptics are there in the literature. [4] TA has been reported with both typical antipsychotics such as haloperidol, perphenazine, molindone, loxapine, and thioridazine,[7] and atypical antipsychotics such as olanzapine,[8] amisulpride,[9] clozapine,[10] risperidone, and levomepromazine. [11] This case is probably one of the few cases to report risperidone as the causative agent of TA.…”

In vitroandin vivosigma 1 receptor imaging studies in different disease states

“…pregnenolone and dehydroepiandrosterone) were effective against negative and cognitive symptoms of schizophrenia and demonstrated antipsychotic activity without producing extrapyramidal side effects. 116,[125][126][127][128][129] The antidepressant drug, fluvoxamine, is a selective serotonin reuptake inhibitor (SSRI) as well as a σ1R agonist with high affinity (K i = 36 nM). Fluvoxamine at therapeutic doses binds to σ1Rs, which was confirmed using PET imaging studies on human brain.…”