Recurrent temporomandibular dislocation as side effect of Fluoxetine usage, a case report

Abstract

Introduction: Allergic reaction to medication corresponds to an undesired side effect of relative frequency in the medical-dental area. Fluoxetine (selective serotonin reuptake inhibitor) is an antidepressant widely prescribed due to its safety, however, extrapyramidal side effects have been described in the literature with prevalence below 0.1%, acute dystonia among them. Dislocation of the temporomandibular joint as a consequence of oromandibular dystonia is an unusual presentation. Case presentation: We report the case of a 15-year-old female patient who after her second dose of Fluoxetine 20 mg presented with multiple and recurrent temporomandibular dislocations, followed by muscle contractures, exophthalmos and seizures. The initial absence of associated neurological signs and symptoms rules out the presence of this situation, which worsens as hours go by and after gathering more information, supression of treatment and Lorazepam IV administration was performed. At 24 and 48 h control mild incidents of spontaneous dislocations were reported, good evolution and total absence of symptoms were reported after a week. Conclusion: Despite it’s low incidence, careful administration of this type of antipsychotic and the search for alternative drugs for people with a history of drug-induced temporomandibular joint dislocation is recommended.