@article{ref1,
title="Akathisia, suicidality, and fluoxetine",
journal="Journal of clinical psychiatry",
year="1992",
author="Hamilton, M. S. and Opler, L. A.",
volume="53",
number="11",
pages="401-406",
abstract="BACKGROUND: The propose link between fluoxetine and suicidal ideation is explained by fluoxetine-induced akathisia and other dysphoric extrapyramidal reactions. METHOD: The following literature is reviewed: (1) the subjective response of schizophrenics to akathisia, including evidence that akathisia gives rise to suicidal ideation; (2) the subjective reports of patients taking fluoxetine; and (3) preclinical studies describing the role of serotonin in the extrapyramidal system and suggesting a mechanism whereby fluoxetine can induce extrapyramidal side effects. RESULTS: The literature suggests that fluoxetine-induced extrapyramidal reactions may be a mediator of de novo suicidal ideation. CONCLUSION: We propose a syndrome which we name Extrapyramidal-Induced Dysphoric Reactions, one extreme manifestation of which is the emergence of suicidal ideation. We further propose a heuristic &quot;Four Neuron Model of the Extrapyramidal Motor System&quot; in which increased serotonin activity, by inhibiting the nigrostriatal dopamine tract, is capable of inducing extrapyramidal side effects.<p /> <p>Language: en</p>",
language="en",
issn="0160-6689",
doi="",
url="http://dx.doi.org/"
}