Reversible parkinsonism caused by selective serotonin reuptake inhibitor

Abstract

Background & Significance : Selective serotonin reuptake inhibitors (SSRI) have been used in the treatment of depression in patients with Parkinson’s disease. It is now controversial that SSRI may aggravate or induce parkinsonism. We report a case with parkinsonism induced by SSRI. Case : A 80-year-old women who had multiple joint pain syndrome referred from rheumatology department for insidiously developed gait disturbance. She have been treated with paroxetine for depression one year ago. She had cogwheel rigidity and resting tremor of both upper extremities, bradykinesia, and postural instability on neurologic examinations. Brain MRI showed multifocal cerebral infarction in both basal ganglia and periventricular white matter. Despite she was treated with L-dopa, amatadine, and bromocriptine, parkinsonian features were not changed. Under the impression of SSRI induced parkinsonism, prescription of paroxetine was discontinued. After this, her symptoms and parkinsonian features were improved. Conclusions or Commentes : We report a patient with a parkinsonism induced by paroxetine, an selective serotonin reuptake inhibitor antidepressant, whose symptoms resolved after discontinuation. It is suggestive that SSRI could induce or aggravate parkinsonian features.