Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jun 8;10(6):880.
doi: 10.3390/biom10060880.

The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial

Evelien Zoons  1 , Marina A J Tijssen  2 , Yasmine E M Dreissen  3 , Marenka Smit  2 , Jan Booij  4
Affiliations
Randomized Controlled Trial

The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial

Evelien Zoons et al. Biomolecules. .

Abstract

Purpose: The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on changes in dopamine D2/3 receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BPND) after a six-week treatment course with escitalopram or placebo. Methods: CD patients had [123I]FP-CIT SPECT (I-123 fluoropropyl carbomethoxy-3 beta-(4-iodophenyltropane) single-photon emission computed tomography) scans, to quantify extrastriatal SERT and striatal DAT, and [123I]IBZM SPECT (I-123 iodobenzamide SPECT) scans to quantify striatal D2/3R BPND before and after six weeks of treatment with either escitalopram or placebo. Treatment effect was evaluated with the Clinical Global Impression scale for dystonia, jerks and psychiatric symptoms, both by physicians and patients. Results: In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BPND. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (p = 0.13) towards lower extrastriatal SERT BPND in the SSRI group (median SERT occupancy of 64.6%). After treatment with escitalopram, patients who reported a positive effect on dystonia or psychiatric symptoms had significantly higher SERT occupancy compared to patients who did not experience an effect. Conclusion: Higher extrastriatal SERT occupancy after treatment with escitalopram is associated with a trend towards a positive subjective effect on dystonia and psychiatric symptoms in CD patients.

Keywords: cervical dystonia; dopamine serotonin; escitalopram; single-photon emission computed tomography (SPECT).

PubMed Disclaimer

Conflict of interest statement

Marina A.J. Tijssen reports grants from the European Fund for Regional Development from the European Union (01492947) and the province of Friesland, ZONMW-TOP (91218013), Dystonia Medical Research Foundation, from Stichting Wetenschapsfonds Dystonie Vereniging, from Fonds Psychische Gezondheid, from Phelps Stichting, and an unrestricted grants from Actelion. The other authors have no financial disclosures.

Figures

Figure 1
Figure 1
Median SERT BPND and interquartile range after treatment with placebo and escitalopram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tarsy D., Simon D.K. Dystonia. N. Engl. J. Med. 2006;355:818–829. doi: 10.1056/NEJMra055549. - DOI - PubMed
    1. Rubio-Agusti I., Parees I., Kojovic M., Stamelou M., Saifee T.A., Charlesworth G., Sheerin U.M., Edwards M.J., Bhatia K.P. Tremulous cervical dystonia is likely to be familial: Clinical characteristics of a large cohort. Parkinsonism Relat. Disord. 2013;19:634–638. doi: 10.1016/j.parkreldis.2013.02.017. - DOI - PMC - PubMed
    1. Gundel H., Wolf A., Xidara V., Busch R., Ladwig K.H., Jacobi F., von R.M., Ceballos-Baumann A.O. High psychiatric comorbidity in spasmodic torticollis: A controlled study. J. Nerv. Ment. Dis. 2003;191:465–473. doi: 10.1097/01.NMD.0000081667.02656.21. - DOI - PubMed
    1. Smit M., Kuiper A., Han V., Jiawan V.C., Douma G., van Harten B., Oen J.M., Pouwels M.E., Dieks H.J., Bartels A.L., et al. Psychiatric co-morbidity is highly prevalent in idiopathic cervical dystonia and significantly influences health-related quality of life: Results of a controlled study. Parkinsonism Relat. Disord. 2016;30:7–12. doi: 10.1016/j.parkreldis.2016.06.004. - DOI - PubMed
    1. Perlmutter J.S., Mink J.W. Dysfunction of dopaminergic pathways in dystonia. Adv. Neurol. 2004;94:163–170. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources