Reactions 1704, p155 - 2 Jun 2018 Oromandibular dystonia: case report An 89-year-old woman developed oromandibular dystonia during treatment with escitalopram [Lexapro] and paroxetine [Paxil] for depression [dosages and routes not stated]. The woman with a history of depression and essential tremor, developed intermittent episodes of dystonia when her jaw remained open. During these episodes, she did not appear distressed, had no problem with secretions, was able to take oral medications [specific drug not stated], but was nonverbal. The staff was not able to passively close her jaw. Initially, the episodes were infrequent and lasted for minutes. However, the episodes became more frequent and progressed to nearly daily occurrences over several weeks with one episode lasting for five hours. She was suspected to have oromandibular dystonia [times to reaction onset not stated]. Anamnesis revealed that she had been treated for depression for years with paroxetine (selective serotonin re-uptake inhibitor [SSRI]). Three months piror, paroxetine had been switched to escitalopram (a more geriatric-friendly SSRI). The potential causes considered were psychogenic, neurological and drug effects. During worsening of her symptoms, she had undergone a dental cleaning, which was implicated in the worsening of oromandibular dystonia. The woman received treatment with lorazepam [Ativan], following which, the duration and number of episodes decreased; however, there was no complete resolution of the symptoms. Then, she was transitioned from lorazepam to clonazepam [Klonopin] and escitalopram was switched back to paroxetine. After these changes, she showed a significant improvement. Author comment: "Of note is that the incidence of drug- induced [oromandibular dystonia] increases with age and greater exposure to certain medications [Tricyclic antidepressants], [selective serotonin re-uptake inhibitors]". Giroux R, et al. The silent scream: Oromandibular dystonia (OMD). Journal of the American Geriatrics Society 66 (Suppl. 2): S103-S104 (plus poster) abstr. B30, Apr 2018. Available from: URL: http://doi.org/10.1111/jgs.15376 [abstract] - USA 803323436 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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