Serotonin-norepinephrine reuptake inhibitors may exacerbate stiff person syndrome
Benavides DR, Newsome SD.
Neurol Neuroimmunol Neuroinflamm 2016; 3:e281.
Stiff-person syndrome (SPS) is a neuroimmunologic disorder characterized by painful spasms and muscle rigidity attributed to impaired inhibitory γ-aminobutyric acid (GABA) descending pathways.The immunopathogenesis remains unknown and the pathogenic significance of antibodies against glutamic acid decarboxylase (GAD) is controversial.
Herein, we report 4 cases of anti-GAD65-positive patients with SPS who had significant worsening of symptoms and disability with the serotonin-norepinephrine reuptake inhibitor (SNRI) duloxetine. While causation cannot be proven, these observations suggest the importance of investigating the relationship between SNRI use and SPS clinical exacerbations.
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