Antidepressant induced excessive yawning and indifference

Jornal Brasileiro de Psiquiatria

Bruno Palazzo Nazar¹  João Hiluy¹  Paulo Mattos¹ 

关键词: Adverse effects;    antidepressive agents;    apathy;    serotonin uptake inhibitors;    yawning;    Efeitos colaterais;    antidepressivos;    apatia;    inibidores de captação de serotonina;    bocejo;   

DOI  :  10.1590/0047-2085000000060

来源: SciELO

【 摘 要 】

Introduction Antidepressant induced excessive yawning has been described as a possible side effect of pharmacotherapy. A syndrome of indifference has also been described as another possible side effect. The frequency of those phenomena and their physiopathology are unknown. They are both considered benign and reversible after antidepressant discontinuation but severe cases with complications as temporomandibular lesions, have been described. Methods We report two unprecedented cases in which excessive yawning and indifference occurred simultaneously as side effects of antidepressant therapy, discussing possible physiopathological mechanisms for this co-occurrence. Case 1: A male patient presented excessive yawning (approximately 80/day) and apathy after venlafaxine XR treatment. Symptoms reduced after a switch to escitalopram, with a reduction to 50 yawns/day. Case 2: A female patient presented excessive yawning (approximately 25/day) and inability to react to environmental stressors with desvenlafaxine. Conclusion Induction of indifference and excessive yawning may be modulated by serotonergic and noradrenergic mechanisms. One proposal to unify these side effects would be enhancement of serotonin in midbrain, especially paraventricular and raphe nucleus.

【 授权许可】

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