An Unexpected Phenomenon: A Case of Citalopram-Induced Dyskinesia.

Dyskinetic movements are characterized as hyperkinetic, repetitive movements of the extremities, facial, and oral musculature, most associated with prolonged dopamine D2 receptor blockade. In rare instances, dyskinetic movements can be brought on by selective serotonin reuptake inhibitor (SSRI) usage via an indirect D2 blockade mechanism, mimicking the D2 blockade observed with dopamine receptor blocking agents (DRBAs), such as in first-generation antipsychotics. This mimicked D2 blockade by SSRIs is said to be due to increased tonic inhibition by serotonin on dopaminergic neurons in the dopaminergic pathways of the brain, specifically the nigrostriatal pathway. In this case report, we look at a patient with a history of cerebral palsy who developed acute dyskinetic movements after short-term citalopram usage. The objective is to bring attention to the possible extrapyramidal side effects (EPS) of SSRI usage.

Management of an Active Oral Bleed Following Dental Implant Therapy Using Lidocaine and Epinephrine Injection in the Presence of an Oral Anticoagulant: A Clinical Report.

Active bleeding in a patient on oral anticoagulants can be difficult to treat. While massive blood loss and hemorrhage are the highest concern, it is the incidental or seemingly benign bleeds that can eventually turn life-threatening. A deeper understanding of locating and controlling slow but constant minor bleeds that are resistant to clotting is important to consider and explore further.