Reactions 1404 - 2 Jun 2012

Citalopram/fluoxetine

Apathy syndrome: 6 case reportsSix men, aged 53–88 years, developed apathy syndrome

while receiving either citalopram or fluoxetine fordepression [routes not stated].

Four men were receiving citalopram 10–40mg daily,while two men were receiving fluoxetine 20mg daily and40mg daily, respectively. All patients subsequentlydeveloped apathy, with two patients developing symptomsbetween 2–4 months after starting serotonin uptakeinhibitors [durations of treatment to reaction onsets notavailable for remaining patients]. Using the ApathyEvaluation Scale, Clinician version, their apathy symptomswere systematically assessed as distinct from pre-existingdepression.

Fluoxetine and citalopram were either tapered to a stopor withdrawn for all patients. Two patients additionallystarted receiving bupropion. Within 1–2 months ofstopping serotonin uptake inhibitors, all patients hadimprovement in their apathy.

Author comment: "Using the Naranjo probability scale,the association of apathy with [serotonin uptake inhibitor]treatment was probable in the first case and possible in therest of the cases."Padala PR, et al. Reversal of SSRI-associated apathy syndrome by discontinuationof therapy. Annals of Pharmacotherapy 46: e8 [4 pages], No. 3, Mar 2012.Available from: URL: http://dx.doi.org/10.1345/aph.1q656 - USA 803071020

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Reactions 2 Jun 2012 No. 14040114-9954/10/1404-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved