Fluoxetine akathisia from

Masand et al. (1991) reported on two cases of suicidality in association with fluoxetine. One of the patients suffered from akathisia. In both cases, the suicidal feelings subsided shortly after stopping the medication. Neither patient had prior suicidal ideation. Both developed violent fantasies (hanging and jumping out a window). 

A pharmacokinetic interaction of risperidone with fluoxetine has been reported (SEDA-22, 71). When 10 schizophrenic patients stabilized on risperidone 4-6 mg/day took fluoxetine 20 mg/day for concomitant depression the mean plasma risperidone concentration increased from 12 to 56 ng/ml at week 4 the concentration of 9-hydroxyrisperidone was not significantly affected (169). One patient dropped out after 1 week because of akathisia associated with a markedly increased plasma risperidone concentration. 

A pharmacokinetic study in 10 patients found that fluoxetine 20 mg daily raised the levels of risperidone 2 or 3 mg twice daily from 12 to 19 nanograms/mL after 3 weeks and to 56 nanograms/mL after 4 weeks. All patients experienced a rise in risperidone levels, but this varied from two to tenfold. One patient withdrew from the study because of severe akathisia and another two patients needed treatment with biperiden to control parkinsonian adverse effects. Similar findings were found in another study. ... 

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