Torticollis under cyclobenzaprine

Pharmacology. 2009;84(2):91-2. doi: 10.1159/000227773. Epub 2009 Jul 8.

Abstract

The muscle-relaxing 5-HT(2) receptor antagonist cyclobenzaprine is structurally closely related to amitriptyline. It is widely used to treat patients presenting with back pain and fibromyalgia. Very rarely cyclobenzaprine toxicity can result in extrapyramidal symptoms, but occurrence of torticollis has not been reported so far. We report on a patient presenting with torticollis and myoclonic movements after treatment with cyclobenzaprine, who was successfully treated with intravenous biperiden. This case might be additional evidence for the necessity of appropriate dosage in case of liver impairment. Secondly there are possibly consequences as regards the therapy of motor side effects.

Publication types

  • Case Reports

MeSH terms

  • Amitriptyline / adverse effects
  • Amitriptyline / analogs & derivatives*
  • Amitriptyline / therapeutic use
  • Biperiden / therapeutic use
  • Humans
  • Male
  • Muscarinic Antagonists / therapeutic use
  • Muscle Relaxants, Central / adverse effects*
  • Muscle Relaxants, Central / therapeutic use
  • Myoclonus / chemically induced
  • Myoclonus / drug therapy
  • Torticollis / chemically induced*
  • Torticollis / drug therapy
  • Young Adult

Substances

  • Muscarinic Antagonists
  • Muscle Relaxants, Central
  • Biperiden
  • Amitriptyline
  • cyclobenzaprine