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Rehabilitation Practice and Science

Translated Title

抗憂鬱藥物與中風患者痙攣之交互作用：病例報告

Abstract

The upper motor neuron diseases (such as cerebrovascular accidents, traumatic brain injury, spinal cord injury, and multiple sclerosis) frequently cause spasticity of extremities. The medications for treating spasticity include baclofen and diazepam, which take their effect in the central nervous system through their GABAergic action. The incidence of depression in patients with spasticity is much higher than that of the normal population. Many doctors prescribe antidepressants for these patients. Two common used antidepressants are tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI). They could increase serotonin amount in synapses, and induce increased excitability of motor neurons, which in turn results in spasticity of extremities. Denervation supersensitivity in upper motor neuron diseases further enhances this phenomenon. The antidepressants are also much more readily bound to protein than baclofen. Thus improper usage of antidepressants can exacerbate spasticity in patients with upper motor neuron lesions. There have been reports on antidepressant-induced spasticity in spinal cord lesion. Our case indicates that use of SSRI can also worsen spasticity in stroke patients. The spasticity improved after discontinuation of SSRI.

Language

Traditional Chinese

First Page

221

Last Page

227

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