![]() The next day, she took sertraline 25 mg at 8:00 PM, following which she exhibited akathisia in addition to anxiety and irritation. She also presented with a dysarthria and malaise. Symptoms related to panic attacks, such as palpitations and dyspnea, were not apparent. ![]() ![]() The following morning, she felt a sense of uneasiness and irritation, which she had never experienced before. Following administration of sertraline, she was unable to sleep and anxious. Concomitant clotiazepam was to be used on an as-needed basis. We diagnosed panic disorder and initiated oral administration of sertraline 25 mg after supper. She was suspected to have psychiatric issues, as she exhibited the same symptoms every night without cause. To our knowledge, this is the first report on the onset of jitteriness/anxiety syndrome caused by a low dose of sertraline.Ī woman in her 1940s without a history of (hypo)manic episodes, drug/alcohol abuse, and anamnestic characteristics or a family history of mental illness was brought to our hospital one night for emergency treatment of palpitations and dyspnea. However, we encountered two cases in which both the patients developed jitteriness/anxiety syndrome on the day after initiation of a regimen of sertraline. reported no significant differences in the occurrence between patients administered sertraline and those administered placebo. Although jitteriness/anxiety syndrome is known to be potentially caused by the use of antidepressants in general, it occurs rarely in patients specifically treated with sertraline. These symptoms were considered to be associated with an increased risk for suicide attempts. According to the United States Food and Drug Administration (FDA) guidelines, jitteriness/anxiety syndrome was referred to as “activation syndrome.” The following ten symptoms of jitteriness/anxiety syndrome were listed: anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (severe restlessness), and (hypo)mania.
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