Extrapyramidal effects of SSRI antidepressants.

(1) About a hundred detailed reports of extrapyramidal adverse effects linked to a "selective" serotonin reuptake inhibitor (SSRI) antidepressant have been published. (2) The effects include acute dystonia, akathisia, and onset or aggravation of parkinsonism. Late-onset dyskinesias are rare. (3) All SSRIs have been implicated. (4) The annual incidence is unclear. It has been estimated at about 1-2 cases per 1 000 patients. (5) In patients with Parkinson's disease, SSRIs are an alternative to tricyclic antidepressants but can worsen the disease itself.