Escitalopram-induced severe akathisia leading to suicide attempt

Pratap, Alok; Akhtar, Sayeed; Sinha, Preema; Bakhla, Ajay Kumar

doi:10.4103/ipj.ipj_72_15

Ind Psychiatry J

2019

DOI: 10.4103/ipj.ipj_72_15

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Escitalopram-induced severe akathisia leading to suicide attempt

Alok Pratap

Sayeed Akhtar

Preema Sinha

et al.

Abstract: Akathisia, a distressing adverse reaction, is usually underdiagnosed or misdiagnosed in patients, who are treated with selective serotonin reuptake inhibitors (SSRIs). Escitalopram-induced akathisia is rarely reported in the literature. We report a case of severe akathisia leading to a suicide attempt in a 25-year-old male induced by 5 mg of escitalopram, that remitted completely after discontinuation of escitalopram and did not reappear later. Patient and their caretakers should be warned of symptoms of akath… Show more

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Cited by 3 publications

References 9 publications

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Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database

Jiang,

Cheng,

et al. 2024

J Psychopharmacol

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Objective: The study aimed to conduct a multidimensional evaluation of potential adverse events (AEs) of escitalopram oxalate based on the FDA adverse event reporting system (FAERS) database. Methods: This study utilized the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma-poisson shrinker (MGPS) to mine and analyze data from the FAERS database from the first quarter of 2004 to the second quarter of 2023. Results: There was a total of 19,854 AE reports related to escitalopram oxalate, extracting 625 preferred terms (PTs), and covering 27 system organ classes (SOCs). The results showed that the number of reports by females was significantly higher than males, accounting for 57.68%. The reporting number was higher in 2018 and 2019, accounting for 9.50% and 10.18% of the total reports, respectively. The main reporters were consumers and other health professionals, accounting for 26.99% and 26.75% respectively. The majority of the reports were primarily from the United States. Newly emerging AE signals such as intentional overdose ( n = 691, ROR 8.51, PRR 8.45, IC 3.05, Empirical Bayesian Geometric Mean (EBGM) 8.35), suicide attempt ( n = 665, ROR 8.58, PRR 8.52, IC 3.06, EBGM 8.42), serum serotonin ( n = 5, ROR 1044.78, PRR 1044.71, IC 2.56, EBGM 392.39), anti-actin antibody positive ( n = 5, ROR 626.87, PRR 626.83, IC 2.56, EBGM 313.91), among others, were not mentioned in the drug’s label. Conclusion: While escitalopram oxalate has clear benefits in the treatment of depression and other mental health disorders, the presence of AEs also suggests risks associated with its use. Particularly concerning are risks of suicide and changes in serum serotonin levels.

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Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database

Jiang,

Cheng,

et al. 2024

J Psychopharmacol

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Escitalopram-induced akathisia in a patient with major depressive disorder: A rare case report

Arshad

Sana

Sajnani

et al. 2022

SAGE Open Medical Case Reports

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Medication-induced akathisia is restlessness with excessive movements developing after initiation/ increasing or decreasing the dose of drugs. Herein, we reported the case of a 38-year-old widowed mother of two children, a known case of major depressive disorder and type 2 diabetes mellitus, who presented with akathisia for 1 month following the use of escitalopram. The patient scored 3 on the Barnes Akathisia Rating Scale global assessment. She was managed by decreasing the offending agent dose and adding clonazepam and propranolol. Her condition gradually improved, and she did not have akathisia by the end of 2 weeks. It is crucial to identify medication-induced akathisia as it is rare and associated with suicidality. Hence, a high index of clinical suspicion and adequate management are warranted.

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Mirtazapine Induced Akathisia:A Case Report

Özturan

DEMİR²

2021

Middle Black Sea Journal of Health Science

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Akathisia is a movement disorder characterized by an inner sense of restlessness and it needs attention because of the increased risk of suicidal behavior. Although akathisia may affect the trunk and arms, it predominantly affects the legs. Akathisia may occur exposure to antipsychotics and antidepressants. Mirtazapine is an antidepressant blocking presynapticα-2adrenergic receptors and 5-hydroxytryptamine (5-HT) 2A/2C, 5 HT 3 and histaminergic postsynaptic receptor. In this single case study, we aimed to present a case of akathisia which occurred after mirtazapine treatment. Case presentation: A fifty -two-years-old woman presented with a-one-month history of decreased sleep and appetite. She had been using antidepressant medication (Fluoxetine 40 mg / day) for five months due to depressive disorder. Mirtazapine 15 mg/day was added to the patient's treatment. Three hours after the first dosage she could not sit even for few minutes and complained of inner restlessness. She reported feeling anxious. Biochemical tests for metabolic/electrolyte parameters were within reference ranges. She had no neurological disease. Mirtazapine was removed and her symptoms resolved in one day. She consulted the department of internal medicine. Her physical examination was normal. Biochemical tests for metabolic/electrolyte parameters were within reference ranges. She had no neurological disease. Mirtazapine was removed and her symptoms resolved in one day. Akathisia is an important side effect because of related to a subjective experience of discomfort that can lead to suicidal behavior. This case illustrates the significant of being alert to any movement disorders in patients treated with mirtazapine.

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Escitalopram-induced severe akathisia leading to suicide attempt

Cited by 3 publications

References 9 publications

Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database

Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database

Escitalopram-induced akathisia in a patient with major depressive disorder: A rare case report

Mirtazapine Induced Akathisia:A Case Report

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