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Table 4 Adjusted reporting odds ratio for the 9 movement disorders between different classes of antidepressants and between the different antidepressants

From: Antidepressants and movement disorders: a postmarketing study in the world pharmacovigilance database

Antidepressants aRORa (95% CI)
Akathisia Bruxism Dystonia Myoclonus Parkinsonism RLS TD Tics Tremor
Tricyclic antidepressants 0.40 [0.32–0.49] 0.13 [0.08–0.21] 0.88 [0.80–0.97] 0.87 [0.74–1.02] 0.77 [0.68–0.87] 0.36 [0.29–0.45] 0.80 [0.69–0.93] 0.48 [0.34–0.67] 0.76 [0.73–0.79]
Serotonin reuptake inhibitors 1.50 [1.34–1.68]* 1.56 [1.35–1.82]* 1.66 [1.55–1.78]* 1.25 [1.12–1.40]* 1.24 [1.14–1.35]* 0.82 [0.73–0.91]* 1.21 [1.08–1.34]* 1.20 [1.00–1.44]* 1.20 [1.16–1.23]*
Monoamine oxidase inhibitors 0.51 [0.25–1.02] 0.34 [0.11–1.07] 0.96 [0.70–1.32] 2.54 [1.81–3.56] 1.12 [0.75–1.66] 0.27 [0.10–0.72] 0.79 [0.46–1.37] 0.19 [0.03–1.36] 0.77 [0.66–0.90]
“Other” antidepressants 0.98 [0.88–1.11] 1.14 [0.98–1.33] 0.59 [0.54–0.64] 0.78 [0.69–0.88] 0.92 [0.84–1.01] 1.89 [1.70–2.10] 0.94 [0.84–1.05] 1.17 [0.97–1.41] 0.97 [0.94–1.00]
Agomelatine 1.31 [0.49–3.50] 1.02 [0.26–4.11] 0.34 [0.11–1.05] 1.30 [0.49–3.47] 1.06 [0.44–2.57] 2.11 [1.00–4.44] 0.33 [0.05–2.34] 1.70 [0.42–6.84] 0.45 [0.29–0.69]
Amineptine – – 0.41 [0.10–1.62] 1.16 [0.29–4.64] 1.03 [0.33–3.22] – – – 0.31 [0.15–0.61]
Amitriptyline 0.22 [0.14–0.34] 0.14 [0.07–0.29] 0.65 [0.56–0.76] 0.88 [0.71–1.09] 0.67 [0.56–0.80] 0.44 [0.33–0.58] 0.60 [0.47–0.76] 0.48 [0.29–0.81] 0.64 [0.60–0.69]
Amoxapine 3.22 [1.60–6.48] – 4.43 [3.07–6.39]* 1.26 [0.41–3.93] 2.02 [1.04–3.92] 0.41 [0.06–2.90] 4.42 [2.50–7.84]* – 0.65 [0.43–0.98]
Bifemelane – – – – 8.28 [1.06–64.44] – – – –
Bupropion 0.32 [0.23–0.46] 0.67 [0.48–0.92] 0.38 [0.32–0.46] 0.46 [0.34–0.63] 0.75 [0.61–0.93] 0.67 [0.52–0.86] 0.83 [0.66–1.05] 0.85 [0.60–1.20] 1.35 [1.28–1.42]*
Butriptyline – – – – – – – – –
Citalopram 1.60 [1.39–1.84]* 1.48 [1.22–1.78]* 0.95 [0.85–1.05] 1.31 [1.13–1.52]* 1.21 [1.08–1.36] 0.98 [0.84–1.14] 1.07 [0.92–1.25] 1.00 [0.77–1.30] 0.92 [0.88–0.96]
Clomipramine 0.63 [0.36–1.08] 0.19 [0.05–0.77] 1.33 [1.05–1.69] 2.73 [2.01–3.71]* 1.33 [0.97–1.82] 0.24 [0.09–0.64] 0.72 [0.43–1.22] 0.79 [0.36–1.78] 1.42 [1.27–1.59]*
Desipramine    0.87 [0.52–1.44] 0.86 [0.32–2.29] 0.62 [0.26–1.50] 0.42 [0.10–1.68] 1.24 [0.59–2.60] 0.40 [0.06–2.83] 1.09 [0.86–1.37]
Desvenlafaxine 0.62 [0.30–1.31] 2.01 [1.18–3.41] 0.66 [0.43–1.02] 0.18 [0.05–0.72] 0.64 [0.35–1.20] 1.37 [0.86–2.18] 1.38 [0.86–2.23] 0.23 [0.03–1.66] 1.17 [1.01–1.35]
Dibenzepin – – – – – – – – 1.76 [0.96–3.23]
Dosulepin 0.47 [0.18–1.26] 0.40 [0.10–1.59] 1.18 [0.80–1.72] 0.32 [0.10–0.98] 0.61 [0.34–1.11] 0.31 [0.10–0.97] 0.88 [0.46–1.70]   0.75 [0.61–0.91]
Doxepin 0.47 [0.22–0.99] 0.12 [0.02–0.88] 0.79 [0.55–1.14] 0.37 [0.17–0.84] 0.82 [0.82–1.22] 0.49 [0.25–0.99] 1.11 [0.72–1.73] 0.61 [0.20–1.89] 0.68 [0.57–0.80]
Duloxetine 1.15 [0.92–1.43] 1.83 [1.46–2.31]* 0.58 [0.48–0.69] 0.74 [0.58–0.96] 0.84 [0.70–1.02] 1.88 [1.61–2.20]* 0.94 [0.76–1.18] 1.26 [0.89–1.80] 1.16 [1.10–1.23]*
Escitalopram 2.02 [1.69–2.42]* 1.62 [1.25–2.10]* 0.81 [0.69–0.95] 0.91 [0.71–1.17] 1.16 [0.97–1.38] 1.11 [0.89–1.38] 1.18 [0.96–1.47] 1.14 [0.79–1.64] 0.97 [0.91–1.04]
Etoperidone – – – – – – – – 6.88 [2.01–23.50]
Fluoxetine 1.02 [0.86–1.20] 0.66 [0.51–0.85] 1.51 [1.39–1.65]* 1.02 [0.85–1.22] 0.94 [0.81–1.09] 0.64 [0.52–0.79] 1.22 [1.04–1.43] 0.94 [0.72–1.24] 0.96 [0.92–1.01]
Fluvoxamine 1.61 [1.13–2.29] 1.28 [0.74–2.22] 1.48 [1.18–1.86]* 1.81 [1.25–2.64] 1.05 [0.73–1.52] 0.68 [0.38–1.23] 0.87 [0.52–1.44] 1.12 [0.58–2.17] 1.73 [1.56–1.92]*
Hypericum perforatum – – 0.26 [0.09–0.82] 0.72 [0.23–2.24] 0.70 [0.26–1.86] 0.71 [0.23–2.20] 0.25 [0.04–1.77] – 0.36 [0.24–0.54]
Imipramine 0.58 [0.34–1.01] 0.08 [0.01–0.58] 1.17 [0.93–1.48] 0.77 [0.46–1.28] 0.65 [0.43–0.97] 0.50 [0.27–0.94] 1.11 [0.75–1.65] 0.76 [0.36–1.61] 0.95 [0.84–1.07]
Iprindole – – 2.01 [0.28–14.52] – – – – – –
Iproclozide – – – – – – – – –
Iproniazide – – – 4.92 [0.69–35.06] 4.61 [1.10–19.37] – – – 0.69 [0.17–2.79]
Isocarboxazid – – – 3.31 [0.46–23.59] – – 2.51 [0.35–18.01] – 0.87 [0.32–2.34]
Lofepramine 0.63 [0.24–1.68]   0.61 [0.34–1.11] 0.31 [0.08–1.25] 0.72 [0.37–1.39]   0.70 [0.29–1.69]   0.70 [0.55–0.89]
Maprotiline 1.23 [0.61–2.46] – 0.49 [0.25–0.93] 0.96 [0.43–2.14] 1.66 [1.05–2.61] 0.15 [0.02–1.08] 0.42 [0.14–1.32] – 0.75 [0.59–0.95]
Medifoxamine – – – – – – – – 1.14 [0.28–4.65]
Melitracen 0.95 [0.13–6.80] – 2.14 [0.95–4.79] – 3.87 [2.00–7.50] – 4.85 [2.17–10.87] 6.06 [1.51–24.42] 1.71 [1.19–2.45]
Mianserin 2.49 [1.66–3.74]* – 0.64 [0.39–1.05] 1.52 [0.96–2.43] 0.75 [0.48–1.16] 0.95 [0.52–1.72] 0.30 [0.11–0.81] – 0.49 [0.39–0.61]
Milnacipran 0.71 [0.23–2.22] 0.35 [0.05–2.50] 0.33 [0.13–0.89] 0.41 [0.10–1.63] 0.67 [0.28–1.60] 0.16 [0.02–1.12] 0.38 [0.10–1.52] – 0.90 [0.70–1.15]
Minaprine – – 2.12 [0.29–15.30] – 2.77 [0.38–20.05] – – – 0.77 [0.19–3.14]
Mirtazapine 2.55 [2.06–3.14]* 0.42 [0.22–0.82] 0.94 [0.76–1.15] 1.61 [1.26–2.06]* 1.24 [1.02–1.50] 5.24 [4.51–6.10]* 1.11 [0.84–1.47] 0.50 [0.24–1.06] 0.71 [0.64–0.78]
Moclobemide 0.83 [0.35–2.00] 0.29 [0.04–2.04] 1.13 [0.71–1.80] 0.83 [0.34–1.99] 1.09 [0.60–1.97] 0.49 [0.16–1.54] 0.31 [0.08–1.23] – 0.72 [0.56–0.93]
Nefazodone 0.88 [0.47–1.65] – 0.73 [0.48–1.11] 0.28 [0.09–0.88] 1.09 [0.66–1.78] 0.37 [0.14–0.99] 0.36 [0.13–0.96] 0.49 [0.12–1.95] 0.64 [0.53–0.78]
Nialamide – – – – – – – – –
Nomifensine – – 0.58 [0.22–1.56] – – – – – 0.53 [0.34–0.83]
Nortriptyline 0.48 [0.24–0.97] 0.33 [0.11–1.01] 0.98 [0.72–1.33] 0.34 [0.15–0.77] 0.63 [0.41–0.98] 0.31 [0.14–0.68] 1.03 [0.67–1.59] 0.36 [0.09–1.44] 0.84 [0.73–0.96]
Opipramol – – 0.66 [0.21–2.04] 0.53 [0.07–3.73] 0.61 [0.15–2.43] 0.52 [0.07–3.67] 0.53 [0.07–3.74] – 0.72 [0.72–1.13]
Oxaflozane – – – – – – – – –
Oxitriptan – – 0.86 [0.12–6.16] 3.02 [0.42–21.71] 3.68 [0.91–14.97] 2.69 [0.38–19.19] – – 1.00 [0.41–2.43]
Paroxetine 1.49 [1.27–1.76]* 1.43 [1.15–1.78] 1.87 [1.70–2.05]* 1.43 [1.21–1.69]* 1.16 [1.01–1.34] 1.18 [0.99–1.41] 1.22 [1.02–1.45] 1.20 [0.90–1.59] 1.52 [1.45–1.58]*
Phenelzine 0.57 [0.18–1.76] – 0.85 [0.48–1.50] 4.85 [3.14–7.49]* 1.28 [0.64–2.58] – 0.37 [0.09–1.50] – 0.83 [0.64–1.08]
Protriptyline – – 1.45 [0.54–3.90] 1.15 [0.16–8.20] – 1.08 [0.15–7.71] – – 0.81 [0.45–1.47]
Quinupramine – – – 26.74 [3.57–200.29] – – – – 1.94 [0.26–14.27]
Reboxetine 1.95 [0.87–4.36] 0.58 [0.08–4.09] 0.70 [0.31–1.55] 0.36 [0.05–2.52] 0.69 [0.22–2.14] 0.36 [0.05–2.57] 0.36 [0.05–2.53]   0.62 [0.42–0.92]
Sertraline 0.85 [0.71–1.02] 1.63 [1.35–1.98]* 1.02 [0.92–1.13] 0.74 [0.61–0.91] 1.23 [1.08–1.39] 0.80 [0.66–0.97] 1.03 [0.87–1.22] 1.33 [1.04–1.71] 1.08 [1.03–1.14]*
Tianeptine 0.35 [0.05–2.45] – 0.28 [0.07–1.12] 1.58 [0.71–3.53] 0.75 [0.34–1.68] 0.26 [0.04–1.86] – – 0.51 [0.35–0.75]
Toloxatone – – – 5.86 [0.82–42.07] – – – – 0.42 [0.06–3.04]
Tranylcypromine – 1.11 [0.28–4.47] 1.06 [0.55–2.04] 2.11 [0.94–4.71] 0.87 [0.32–2.32] 0.31 [0.04–2.18] 2.20 [1.09–4.42] 0.94 [0.13–6.69] 0.83 [0.60–1.16]
Trazodone 1.08 [0.80–1.46] 0.44 [0.23–0.85] 1.01 [0.83–1.24] 0.48 [0.31–0.74] 1.03 [0.83–1.28] 1.01 [0.75–1.36] 1.31 [1.01–1.69] 0.58 [0.29–1.17] 0.73 [0.66–0.81]
Trimipramine 1.06 [0.44–2.55] 0.40 [0.06–2.81] 1.57 [1.00–2.47] 0.63 [0.20–1.95] 0.52 [0.22–1.25] 0.81 [0.30–2.15] 1.30 [0.62–2.74] – 0.93 [0.72–1.20]
Tryptophan 0.10 [0.03–0.41] 0.08 [0.01–0.54] 0.07 [0.03–0.19] 0.05 [0.01–0.28] 0.05 [0.01–0.20] 0.04 [0.01–0.30] 0.09 [0.02–0.35] 8.13 [6.06–10.92]* 0.36 [0.30–0.43]
Venlafaxine 0.98 [0.80–1.19] 1.98 [1.63–2.42]* 1.02 [0.90–1.15] 1.31 [1.09–1.57] 1.22 [1.06–1.42] 1.25 [1.06–1.49] 1.35 [1.14–1.59]* 0.81 [0.57–1.16] 1.07 [1.02–1.13]
Vilazodone 0.75 [0.24–2.32] 2.04 [0.85–4.92] 0.18 [0.05–0.72] – 1.48 [0.74–2.97] 3.87 [2.40–6.26]* 1.35 [0.61–3.02] 0.64 [0.09–4.54] 1.41 [1.13–1.76]
Viloxazine – – – 4.66 [1.93–11.28] 1.57 [0.58–4.22] – – – 0.43 [0.19–0.95]
Vortioxetine 2.17 [1.03–4.57] 4.71 [2.52–8.80]* 0.51 [0.21–1.23] 0.31 [0.04–2.15] 0.47 [0.12–1.87] 0.82 [0.26–2.55] 0.87 [0.28–2.71] 2.23 [0.72–6.95] 0.59 [0.41–0.85]
Zimeldine – – 0.47 [0.12–1.90] 1.22 [0.30–4.87] – – – – 0.47 [0.26–0.82]
  1. CI confidence interval, aROR adjusted reporting odd ratio; RLS, restless legs syndrome; TD, tardive dyskinesia
  2. aAdjusted ROR were calculated in adjusted univariate logistic regression analysis, with adjustment for age, gender, drugs described as able to induce movement disorders, and drugs used to treat movement disorders
  3. * Significant association was defined as adjusted ROR > 1 with α threshold of 0.001, and the number of cases being at least 10
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