Oculogyric Dystonic Reaction to Escitalopram with Features of Anaphylaxis Including Response to Epinephrine

Vol. 140, No. 1, 2006

Free Abstract Article (Fulltext) Article (PDF 211 KB)

Case Report

Oculogyric Dystonic Reaction to Escitalopram with Features of Anaphylaxis Including Response to Epinephrine
Ojas P. Patel^a, Michael R. Simon^b

^aDepartment of Internal Medicine, Henry Ford Health System,
^bSection of Allergy and Clinical Immunology, Division of Pulmonary and Critical Care Medicine, Henry Ford Health System and the Departments of Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, Mich., USA

Address of Corresponding Author

Int Arch Allergy Immunol 2006;140:27-29 (DOI: 10.1159/000091840)

Key Words

Dystonia
Anaphylaxis
Escitalopram
Epinephrine

Abstract

Dystonia-associated features of anaphylaxis, including tongue swelling, and chest and throat tightness, have been rarely reported with selective serotonin reuptake inhibitor (SSRI) use. The patient is a 44-year-old woman who presented with palpitations, diaphoresis, dyspnea, swelling of the lips and tongue, and fixed upward deviation of her right eye following inadvertent ingestion of 20 mg of escitalopram in addition to her usual 10-mg dose. She reported transient resolution of all symptoms after autoinjector aqueous epinephrine administration (0.3 mg), with recurrence of symptoms after 35 min. The patient presented with one prior episode of anaphylactic symptoms and dystonia. She also reported one episode with purely anaphylactic features of swelling of lips and tongue, difficulty breathing and syncope. This case represents a unique dose-dependent episode of escitalopram-associated oculogyric dystonia with anaphylactic features. The transient resolution of the associated features of dystonia with intramuscular epinephrine administration is unique and suggests a common pathophysiology of the dystonic and anaphylactic symptoms.

Author Contacts

Correspondence to: Dr. Michael R. Simon
Allergy and Clinical Immunology
Henry Ford Health System, One Ford Place
Detroit, MI 48202 (USA)
Tel. +1 313 876 2662, Fax +1 313 876 8072, E-Mail mrsimonmd@sbcglobal.net

Article Information

Received: October 20, 2005
Accepted after revision: December 19, 2005
Published online: March 2, 2006
Number of Print Pages : 3
Number of Figures : 1, Number of Tables : 0, Number of References : 11

Medline Abstract (ID 16514246)

Download Citation

Cited In

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.