Antidepressant-induced Paradoxical Anxiety, Akathisia, and Complex
Vocal Tics in a Patient with Panic Disorder and Crohn’s Disease: A Case
Report

Azriel      HK Koh; Soon   Shan   Loh; Leslie      Lim

doi:10.2174/0115748863270093231114075934

Abstract

Background: Antidepressant-induced paradoxical anxiety is a fairly common phenomenon seen in patients who are initiated on antidepressants. However, akathisia is a very uncommon manifestation of antidepressants. Much more rarely, antidepressants are also associated with the emergence of motor and vocal tics. This case adds to the growing literature of rare adverse events induced by antidepressants and aims to stimulate future research into the mechanism and risk factors of this phenomenon.

Case Presentation: In this case report, we describe a patient with panic disorder and co-morbid Crohn’s disease who developed worsening anxiety, akathisia and vocal tics upon initiation of fluvoxamine. This is the first case report to describe the emergence of both akathisia and vocal tics in the same patient following antidepressant initiation. After discontinuation of fluvoxamine, the patient’s symptoms resolved.

Conclusion: Antidepressant-induced akathisia and tics are often distressing both to the patient and their loved ones, and can be very puzzling to the clinician. It is important for clinicians to recognise that, although rare, antidepressants can adverse effects. When these symptoms arise, it should prompt immediate discontinuation of the offending antidepressant.

Keywords: Antidepressant, fluvoxamine, paradoxical anxiety, akathisia, tics, panic disorder, crohn’s disease.

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DOI https://dx.doi.org/10.2174/0115748863270093231114075934	Print ISSN 1574-8863
Publisher Name Bentham Science Publisher	Online ISSN 2212-3911

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Antidepressant-induced Paradoxical Anxiety, Akathisia, and Complex Vocal Tics in a Patient with Panic Disorder and Crohn’s Disease: A Case Report

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