Desvenlafaxine as a Potential Trigger for Extrapyramidal Symptoms: A Case Series

Abstract While extensive research has been conducted on the neural mechanisms underlying extrapyramidal side effects (EPS) caused by antipsychotics, significantly less attention has been paid to similar effects induced by antidepressants. Emerging evidence suggests that serotonergic modulation may suppress dopaminergic activity in the striatum, potentially leading to EPS. Notably, most reported cases of antidepressant-induced EPS, particularly with selective serotonin and norepinephrine reuptake inhibitors such as desvenlafaxine, have occurred in female patients and frequently manifest as secondary parkinsonism. Symptom resolution following the withdrawal of the offending agent supports a causal relationship. These findings underscore the need for further systematic investigation into the pathophysiology, risk factors, and clinical management of antidepressant-induced extrapyramidal symptoms.