TY  - JOUR
PY  - 1992//
TI  - Akathisia, suicidality, and fluoxetine
JO  - Journal of clinical psychiatry
A1  - Hamilton, M. S.
A1  - Opler, L. A.
SP  - 401
EP  - 406
VL  - 53
IS  - 11
N2  - 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 "Four Neuron Model of the Extrapyramidal Motor System" in which increased serotonin activity, by inhibiting the nigrostriatal dopamine tract, is capable of inducing extrapyramidal side effects.<p />  <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/
ID  - ref1
ER  -