SSRIs dyskinesias caused

SSRIs cause a wide range of neurological impairments. Spigset (1999) found the following neurological reports in order of frequency parethesias, headache, dizziness, tremor, seizures, acute dystonia, dyskinesia, muscle cramps, muscle weakness, parkinsonism, muscle stiffness, akathisia, myoclonus, extrapyramidal reactions, increased muscle tone, and migraine. There have been reports of irreversible tardive dyskinesia caused by SSRIs (see subsequent section). 

In fact, the SSRI-RBD link sounds a lot like the Thorazine-tardive dyskinesia tie-in, doesn t it What possibly common underlying mechanism could unite these apparently disparate phenomena One answer is dopamine, whose production by the substantia nigra is deficient in spontaneous Parkinsonism. Dopamine is blocked, hence rendered functionally deficient, by the antipsychotics that produce both immediate and delayed Parkinsonian side effects. Serotonin inhibits dopamine, which means that potentiating serotonin with SSRIs could also render dopamine less functionally efficacious. Acetylcholine is in dynamic reciprocity with both serotonin and dopamine. Acetycholine causes an increase in dopamine s efficacy in some circuits and a decrease in others. 

The risk of causing EPS, another SSRI-induced neurologist disorder, was apparent from early on. The FDA s Kapit (1986) warned, It is possible that a tardive syndrome related to fluoxetine may exist. It will be necessary to be on the lookout for such events (p. 32). By January 1993, more than two dozen reports of Prozac-induced tardive dyskinesia had reached the FDA (1993), but the profession has not taken much notice. Numerous case reports confirm that the SSRIs can produce persistent extrapyramidal reactions, including tardive dystonia with painful and disabling spasms of the neck and shoulder musculature. 

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