Probable fluoxetine-induced carotidynia.

摘要

Carotidynia is a focal cervical pain that involves the anatomical territory of the affected carotid artery and often radiates to the ipsilateral side of the face or ear. On the basis of medical history and age, carotidynia has been conventionally classified into classic (non-migrainous), migrain-ous, and vascular variants. To our knowledge, iatrogenic carotidynia is an unknown or at least unreported phenomenology. We present a patient who developed carotidynia secondary to treatment with a selective serotonin reuptake inhibitor (SSRI). A 43-year-old middle-eastern man presented to the clinic with a history of severe and occasional migrainous attacks and mild depression. They favourably responded to daily 20 rng fluoxetine for 5 months, before the patient gradually started to experience a left intercostal pain that soon progressed to become bilateral, steadier, episodic, stabbing on deep breathing and movement of the trunk, and otherwise distressing and moderate in severity. At that time, the patient chose to increase the dose of fluoxetine to 40 mg per day to enhance its antimigrainous effect.