[Fluoxetine, akathisia and suicide]

Abstract

Several cases of suicidal thinking or suicidal behavior during fluoxetine treatment are described in the literature. Akathisia or dysphoric extrapyramidal reactions may explain the emergence of suicidal ideation during fluoxetine treatment. Retrospective and controlled studies found no relationship between fluoxetine and the emergence of suicidal ideation. Some cases reports of akathisia or suicidal ideation with other selective serotonin reuptake inhibitors (SSRIs) suggest that same mechanisms (pharmacokinetic or pharmacodynamic interactions) are involved in extrapyramidal effects during treatment with SSRIs. The clinical use of SRIs is discussed.