SSRI-induced parkinsonism may be an early sign of future Parkinson's disease.

Sir: In recent years, there have been several case reports of extrapyramidal symptoms as a result of treatment with selective serotonin reuptake inhibitors (SSRIs). These symptoms include dystonia, akathisia, and parkinsonism. In most previously reported cases, the patients had preexisting brain diseases, but some movement disorders developed after initiation of SSRI treatment in both young healthy and vulnerable old patients. Furthermore, SSRIs might change the symptom profile of preexisting idiopathic Parkinson's disease. There are reports of deterioration of parkinsonian patients taking SSRIs. The literature on this subject was recently reviewed by Caley.