Rhabdomyolysis After Escitalopram Treatment in a Young Adult With Melancholic Depression

Lecardeur, Laurent; Lefebvre, Aline; Meunier-Cussac, Sophie

doi:10.1097/jcp.0000000000000234

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…The results of disproportionality analysis in our work showed that significant signals were detected between rhabdomyolysis and SSRIs treatment. Further analysis confirmed the previously known associations of rhabdomyolysis with escitalopram, fluoxetine, sertraline, citalopram and fluvoxamine as reported in case reports 10 – 14 . However, our analysis did not find sufficient evidence to suggest a significant signal of paroxetine-associated rhabdomyolysis.…”

Section: Discussionsupporting

confidence: 87%

“…However, there have been several cases of rhabdomyolysis manifesting up to a decade after the administration of SSRIs, making it difficult to assess the temporal relationship between the two from a pharmacokinetic perspective 11 . Previous studies have reported cases of sertraline-induced rhabdomyolysis after 3 months of therapy 24 , escitalopram-induced rhabdomyolysis after 2 months of therapy 10 , and pravastatin-induced rhabdomyolysis after more than 3 years of therapy 25 . These cases, along with our study, indicate that the risk of drug-induced rhabdomyolysis may persist even after long term use of certain medications.…”

Section: Discussionmentioning

confidence: 99%

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Exploring the association between selective serotonin reuptake inhibitors and rhabdomyolysis risk based on the FDA pharmacovigilance database

Wang

Lin

et al. 2023

Sci Rep

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Rhabdomyolysis is a syndrome potentially fatal and has been associated with selective serotonin reuptake inhibitors (SSRIs) treatment in a few case reports. Herein, we purpose to establish the correlation between SSRIs use and rhabdomyolysis using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database. We conducted an analysis on reports that were submitted to the FAERS database during the period between January 1, 2004, and December 31, 2022. Four algorithms, including reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM), were employed to quantify the signals of rhabdomyolysis associated with SSRIs. In total, 16,011,277 non-duplicated reports were obtained and analyzed. Among 33,574 reports related to rhabdomyolysis, SSRIs were classified as primary suspected drug in 889 cases. Disproportionality analysis identified a positive signal between rhabdomyolysis and SSRIs (ROR: 2.86, 95% CI 2.67–3.05; PRR: 2.84, χ2: 1037.16; IC0.25 = 1.39; EBGM0.5 = 2.64). Among six SSRIs, fluvoxamine had the strongest signal (ROR: 11.64, 95% CI 8.00–16.93; PRR: 11.38, χ2: 265.51; IC0.25 = 2.41; EBGM0.5 = 8.31), whereas no significant signal of rhabdomyolysis was detected for paroxetine (ROR: 1.83, 95% CI 1.55–2.15; PRR: 1.82, χ2: 53.82; IC0.25 = 0.73; EBGM0.5 = 1.59). After excluding cases co-administered with statins, the signal of rhabdomyolysis associated with SSRIs remains significant. Our analysis reveals that there are differences in safety signals among six SSRIs in respect to the risk of rhabdomyolysis, with fluvoxamine displaying the highest risk signal, while paroxetine did not show a significant signal. Given the potentially lethal nature of rhabdomyolysis, healthcare professionals should inform patients of the potential risk of rhabdomyolysis associated with SSRIs prior to initiating treatment.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Exploring the association between selective serotonin reuptake inhibitors and rhabdomyolysis risk based on the FDA pharmacovigilance database

Wang

Lin

et al. 2023

Sci Rep

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“…The use of SSRIs in child and adolescent populations has been rising, and typically include fluoxetine, sertraline, citalopram, escitalopram, paroxetine and fluvoxamine. Reported cases throughout the world regarding the occurrence of rhabdomyolysis with SSRIs have concerned sertraline, escitalopram and paroxetine 6–8. A young adult in their 20s took a dose of 100 mg of sertraline monotherapy and developed signs consistent with rhabdomyolysis 9.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a male adolescent associated with monotherapy of fluvoxamine

et al. 2022

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Rhabdomyolysis is a syndrome resulting from striated muscular breakdown, which may occur due to drug therapy with agents such as selective serotonin reuptake inhibitors (SSRIs). Although studies have shown that fluvoxamine can rarely cause myalgia, there are no reported cases of rhabdomyolysis due to fluvoxamine monotherapy. Here we describe a case of rhabdomyolysis due to fluvoxamine monotherapy for obsessive-compulsive disorder. The young adolescent developed pain in the extremities, and an increase in serum creatine kinase (CK) and myoglobin during fluvoxamine treatment. These adverse reactions were reversed immediately after the medicine was changed to another SSRI—sertraline. This is the first reported case of fluvoxamine-associated rhabdomyolysis. It is advisable to determine serum CK levels before starting fluvoxamine treatment, and then at regular intervals, to avoid the occurrence of severe acute kidney injury with possible life-threatening complications.

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Escitalopram

2015

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Rhabdomyolysis After Escitalopram Treatment in a Young Adult With Melancholic Depression

Cited by 6 publications

References 18 publications

Exploring the association between selective serotonin reuptake inhibitors and rhabdomyolysis risk based on the FDA pharmacovigilance database

Exploring the association between selective serotonin reuptake inhibitors and rhabdomyolysis risk based on the FDA pharmacovigilance database

Rhabdomyolysis in a male adolescent associated with monotherapy of fluvoxamine

Escitalopram

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