Reactions 1364 - 13 Aug 2011

SCitalopram

Parkinsonian syndrome in an elderly patient:case report

A 67-year-old woman developed Parkinsonian syndromewhile receiving citalopram for depressive syndrome.

The woman, who had a history of arterial hypertensionand heart arrhythmia, presented to the emergencydepartment with acute-onset gait difficulties and"generalised slowness". She had first developed symptomsapproximately 2 weeks after the introduction of citalopram20mg once daily [route not stated]. Examination revealed ahypophonic voice, reduced facial expression, and bilateralrigidity and bradykinesia, which were more severe on herleft extremities. Mild resting and postural tremor of her lefthand were apparent, and she walked with short steps,forward flexion of the trunk, and a reduced arm swing. Shewas unable to maintain the balance on a retropulsion test,and achieved a score of 36/108 on the Unified ParkinsonDisease Rating Scale (UPDRS). She was referred for asecond opinion and re-examined 1 month later where shescored 4/108 on the UPDRS, consistent with a fullrecovery.

The woman reported that her symptoms had improvedwithin 3 days of discontinuing citalopram, and hadcompletely resolved 1 week later.

Author comment: "The Naranjo Adverse Drug ReactionsProbability scale was applied, and the patient’s score was 8,indicating a high probability of adverse drug reaction."Miletic V, et al. Citalopram-induced parkinsonian syndrome: case report. ClinicalNeuropharmacology 34: 92-3, No. 2, Mar-Apr 2011 - Croatia 803058754

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Reactions 13 Aug 2011 No. 13640114-9954/10/1364-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved