Blue,

I have wondered if it wasn't a trigger for me as well. My tremor emerged around the same time I was put on Paxil for anxiety. At that time, the tremor was not at all Parkinsonian although it was only in one hand. I wasn't on Paxil long at all as it made the tremor worse.

I recall seeing legal cases, I thought, like three-four years ago, linking Paxil with. I should have printed them out because it is like they have all but disappeared.

However, this is damning enough in my book. It's a book written by a psychiatrist who watched SSRIs ruin lives in the 90's as patients were left with all sorts of neurological problems ranging from tics to full blow Tardive Dyskinesia with Parkinsonism in the spectrum of movement disorders. The book is Prozac Backlash The link is to Amazon where you can read the first chapter of the book where he describes a number of patients who began exhibiting weird tics, myoclonic jerks, dystonia, etc. after being on SSRIs for a short time. In most cases, the problems go away after the drug is stopped, but not in all cases....

I think the standard response you will see in research case studies of people who took SSRIs and showed Parkinsonian symptoms was that the person had the disease all along and that the drug just moved it to the front burner. The medico-pharma spin on it is that it was simply a matter of time that PD reared its ugly head in these patients, not that the drug is even remotely responsible or a main trigger. It is amazing that they can tell our futures.

Further, do a search on Pubmed. The link between PD and SSRIs has been documented since the mid 90's. Yet, go to your neurologist or psychiatrist for an anti-depressant, and the first thing they'll likely suggest is....an SSRI!!

J Clin Psychiatry. 1996 Oct;57(10):449-54.
Movement disorders associated with the serotonin selective reuptake inhibitors.

Leo RJ.

Department of Psychiatry, School of Medicine, State University of New York at Buffalo 14215, USA.

Comment in:

* J Clin Psychiatry. 1998 Mar;59(3):133.
* J Clin Psychiatry. 1997 Sep;58(9):403-4.

Abstract

BACKGROUND: To review the case reports and case series of movement disorders ascribed to the use of serotonin selective reuptake inhibitors (SSRIs).

METHOD: Reports of SSRI-induced extrapyramidal symptoms (EPS) in the literature were located using a MEDLINE search and review of bibliographies.

RESULTS: Among the 71 cases of SSRI-induced EPS reported in the literature, the most common side effect was akathisia (45.1%), followed by dystonia (28.2%), parkinsonism (14.1%), and tardive dyskinesia-like states (11.3%). Among patients with Parkinson's disease treated with SSRIs, there were 16 cases of worsening parkinsonism. Patients who developed dystonia, parkinsonism, or tardive dyskinesia were older on average than patients with akathisia; 67.6% of affected patients were females. Fluoxetine, the most commonly prescribed SSRI to date, was implicated in 53 (74.6%) of cases of SSRI-induced EPS. Several reports (57.7%) were confounded by the concomitant use of other medications that can contribute to the development of EPS.

CONCLUSION: SSRI-induced EPS are probably related to agonism of serotonergic input to dopaminergic pathways within the CNS. Several patient-dependent and pharmacokinetic variables may determine the likelihood that EPS will emerge. Although these side effects are infrequent, clinicians should be alert to the possibility of their occurrence.