Sertraline

I have been prescribed adrenaline but developed diarrhoea and feeling agitated so have started taking half tablet instead of a whole one and see if I get used to it is this a good idea no diarrhoea but feeling agitated and tired has anyone else taken this medication and how did they get on. I also take Madopar 2 every 3 hours.

I am writing again as just noticed my laptop has changed Sertraline to adrenaline its so annoying when it does this !!

I only took Sertraline for 13 days. Made my muscle spasms (dystonia) spread caused akathisia (restlessness/agitation) & onset of parkinsonian symptoms.

https://www.medicines.org.uk/emc/product/7162/smpc#gref
Sertraline 50 mg Tablets Lupin Healthcare (UK) Ltd Last updated on emc: 18 Aug 2020
This information is intended for use by health professionals
4.8 Undesirable effects: Psychiatric disorders: anxiety, depression, agitation, nervousness,

https://www.medicines.org.uk/emc/product/1070/smpc
Lustral [Sertraline/Zoloft] 50mg film coated tablets Pfizer Limited . Date of revision of the text 02/2018
This information is intended for use by health professionals

Akathisia/psychomotor restlessness
The use of sertraline has been associated with the development of akathisia, characterised by a subjectively unpleasant or distressing restlessness and need to move often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. In patients who develop these symptoms, increasing the dose may be detrimental.

https://www.medicines.org.uk/emc/product/6924/smpc
Madopar 100 mg/25 mg Dispersible Tablets Roche Products Limited SMPC Last updated on emc: 08 Apr 2020
This information is intended for use by health professionals
4.8 Undesirable effects: Nervous System Disorder: … anxiety, agitation, insomnia, drowsiness, depression, aggression…

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123446/
Akathisia: overlooked at a cost Hiroko Akagi and T Manoj Kumar Journal of Clinical Psychiatry 52 (1991), 491–493.
Akathisia has been well documented as a common and distressing side effect of antipsychotic drugs and an important cause of poor drug compliance. However, even in psychiatric settings, it is not recognised readily. In one study of movement disorders induced by neuroleptics, akathisia was diagnosed in only 26% of patients who had it.
Patients often find it difficult to explain the inner restlessness or mental unease, and the condition may easily be interpreted as acute anxiety or depression. Therefore diagnosis relies on a high index of suspicion on the part of the clinician.

Thus when patients present with acute symptoms of agitation and restlessness, their medication should first be checked for a recent introduction or increase in the dose of drugs associated with akathisia. There may be a history of previous similar episodes, as in all our cases, which will help in the diagnosis. Such individual susceptibility may indicate a genetic predisposition. The diagnosis can be confirmed retrospectively when the symptoms abate rapidly with the withdrawal of the offending drug.
Non-neuroleptic drugs reported to cause akathisia Antiemetics: Metoclopramide, prochlorperazine, [domperidone] Antidepressants: Tricyclics, selective serotonin reuptake inhibitors (fluoxetine, paroxetine, sertraline), venlafaxine, [nefazodone] Calcium channel blockers: Cinnarizine, flunarizine (also H1 antagonists), [diltiazem] Others: Methyldopa, levodopa and dopamine agonists, [lithium carbonate], [buspirone], [anticonvulsants], [pethidine], [interferon alfa], [sumatriptan]
https://www.socialaudit.org.uk/58090-DH.htm#ANTIDEPRESSANTS%20AND%20SUICIDE
ANTIDEPRESSANTS AND SUICIDE BRIEFING PAPER 20 JUNE 2003 DAVID HEALY

In general across clinical trials with SSRIs in both depressed and non-depressed populations, the results show a consistent pattern of drug-induced conditions variously described as agitation-anxiety-nervousness-hyperkinesis-tremor
Lustral/Zoloft [Sertraline]…In the multiple dose studies, a clear preponderance of these studies have shown significant levels of agitation, turmoil or emotional dysregulation, sometimes after a single dose only.


A Case of SSRI Induced Irreversible Parkinsonism S.Dixit, S.A.Khan, and S.Azad J Clin Diagn Res. 2015 Feb; 9(2):
SSRI are known to cause reversible or irreversible motor disturbances through pathophysiological changes in basal ganglion motor system by altering the dopamine receptors postsynaptically.
Review of case reports related to SSRI induced EPS revealed akathisia (45.1%) followed by dystonic reactions (28.2%), parkinsonism (14.1%) and tardive dyskinesia (11.3%).