本案例是報告一位 67  歲女性重鬱症患者，因為使用 paroxetine  而導致錐體外徑症狀（extrapyramidal  symptoms, EPS）。由於與藥物不良反應發生的時間呈現相關聯性，且出現 口顎異動症（ oromandibular   dyskinesia ）和帕金森氏症（ parkinsonism ），懷疑病人使用 paroxetine 後導致發展成為 EPS。然而，選擇性血清素再吸收抑制劑（selective serotonin reuptake  inhibitor,  SSRI）導致 EPS 的機轉尚未很清楚，推測可能與血清素影響錐體外徑多 巴胺（dopamine）活性有關。雖然 SSRI 引起的  EPS 並不常見，但對於使用這些藥物的病 人仍應提供適當的照護，醫護人員亦應警覺可能發生的不良反應，定期監測藥物使用的情況。

We report a 67-years woman who developed extrapyramidal symptoms (EPS) after paroxetine treatment for her major depression. The consequential adverse reactions, including extrapyramidal symptoms, oromandibular dyskinesia and parkinsonic syndromes, after drug treatment suspected to be related to a selective serotonin reuptake inhibitor (SSRI), paroxetine. Although the mechanism of selective serotonin reuptake inhibitor-induced extrapyramidal symptoms is not clear, we speculate that it may be caused by serotonin’s inhibitory effects at the extrapyramidal dopamine pathway. The previous reports related to selective serotonin reuptake inhibitor-induced extrapyramidal symptoms were rare, however, we still suggest that clinicians should provide appropriate care for patients with paroxetine treatment, aware the possibilities of paroxetine-induced adverse reactions, and monitor the usage of these kind of drugs periodically.