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Re: CPK level increase - antidepressant dystonia ? » SLS

Posted by Sunnely on July 21, 2000, at 22:41:30

In reply to Re: CPK level increase - antidepressant dystonia ? » Sunnely, posted by SLS on July 21, 2000, at 9:31:40

> Which of the "newer" antidepressants are capable of causing dystonic reactions? What mechanisms might be responsible for this?

Virtually all of the SSRIs have been reported to cause dystonic reaction (muscle stiffness).[1,2] The exact mechanism is unclear. One hypothesis is that, SSRIs do this by an inhibition of dopamine release from the nigrostriatal pathway (one of the 4 major dopamine pathways) arising from the inhibitory serotonergic input from the raphe.[3] Another hypothesis proposed is that, at least some SSRIs can cause extrapyramidal movement disorders (such as neck stiffness) by acting on the sigma 2 receptors located in the red nucleus.[3]

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> Also, out of curiousity, are there different types of CPK depending upon the type of muscle it originates from?

CPK is found in relatively high concentrations in 3 tissues: the heart, skeletal muscles, and the brain. The skeletal muscle CPK is called CPK-MM; heart is CPK-MB; brain is CPK-BB.

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> It is so tempting to ask you a trillion questions. I apologize.

Fogettaboutit. Ciao! :)

Sources:

1] Fluoxetine, Sertraline, and Extrapyramidal Reactions. In: International Drug Therapy Newsletter, November 1998.

2] Paroxetine, Fluvoxamine, Citalopram and Extrapyramidal Reactions - Part II. In: International Drug Therapy Newsletter, December 1998.

3] Leonard BE, Faherty C: SSIs and movement disorders: Is serotonin the culprit? Human Psychopharmacology 1996;11:S75-S82.


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