Sertralinle tedavi sırasında ortaya çıkan oromandibular distoni

Seçici serotonin geri alım inhibitörleri (SSGİ) depresyon başta olmak üzere, anksiyete bozuklukları, yeme bozuklukları, dürtü kontrol bozuklukları gibi çeşitli ruhsal bozuklukların tedavisinde genellikle ilk yeğlenen ilaçlardır. Sertralin bir miktar dopamin gerialım inhibisyonu da yapan bir seçici serotonin geri alım inhibitörüdür. Olası yan etkileri arasında uyuklama, sinirlilik, terleme, uyuşukluk, uykusuzluk, baş dönmesi, bulantı, titreme, deri döküntüsü, hazımsızlık, iştah kaybı, baş ağrısı, ishal, ejakülasyon bozukluğu, ağız kuruluğu ve kilo kaybı vardır. Nadiren akatizi, distoni, parkinsonizm, geç diskinezi gibi ekstrapiramidal yan etkilere neden olabileceği bildirilmiştir. Akut distoni bir psikiyatrik acildir. Genellikle antipsikotik kullanımı sonucunda gelişir, ancak antiemetik ve antidepresanlar ile de gelişebilir. Bu olguda, uyum bozukluğu tanısıyla 50 mg/gün sertralin kullanan hastada ortaya çıkan oromandibular distoni anlatılarak, nadiren de olsa SSGİ kullanan hastalarda ekstrapiramidal yan etkilerin ortaya çıkabileceğine dikkat çekilmek istenmiştir. Klinisyenler SSGİ'lerin ekstrapiramidal sistem (EPS) yan etkilerinin olabileceğini akıllarında tutmalı ve bu konuda dikkatli olmalıdırlar.

Oromandibular dystonia with sertraline treatment: a case report

Selective serotonin reuptake inhibitors are generally first choice drugs in the treatment of depression, anxiety disorder, eating disorder and various psychiatric disturbances, such as impulse control disorder. Sertraline is a selective serotonin reuptake inhibitor. It also makes dopamine reuptake inhibition. It may show somnolence, nervousness, sweating, drowsiness, insomnia, dizziness, nausea, chilling, skin rash, dyspepsia, loss of appetite, headache, diarrhea, ejaculation disorder, dry mouth, and weight loss as side effects. It has been reported that akathisia, dystonia, tardive dyskinesia and Parkinsonism may be seen as the extrapyramidal system findings during use of sertraline. Acute dystonia is a psychiatric emergency. It develops not only due to use of antipsychotics but, it has also been reported to occur due to use of antiemetics and antidepressants as well. In this report, we present a case with oromandibular dystonia, which developed during 50 mg sertraline treatment on the patient with adjustment disorder. Clinicians should always keep in their mind that there may be extrapyramidal side effects during use of selective serotonin reuptake inhibitors.

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