Doobay Ravi, Sun Lili, Shah Amish, Masuta Pardeep, Shepherd Zachary
Internal Medicine, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA.
Case Rep Neurol Med. 2017;2017:4318450. doi: 10.1155/2017/4318450. Epub 2017 Apr 11.
Choreoathetoid movement secondary to cocaine use is a well-documented phenomenon better known as "crack dancing." It consists of uncontrolled writhing movements secondary to excess dopamine from cocaine use. We present a 32-year-old male who had been using cocaine for many years and was recently started on paroxetine, a selective serotonin reuptake inhibitor (SSRI) for worsening depression four weeks before presentation. He had been doing cocaine every 2 weeks for the last three years and had never "crack danced" before this episode. The authors have conducted a thorough literature review and cited studies that suggest "crack dancing" is associated with excess dopamine. There has never been a documented case report of an SSRI being linked with "crack dancing." The authors propose that the excess dopaminergic effect of the SSRI lowered the dopamine threshold for "crack dancing." There is a communication with the Raphe Nucleus and the Substantia Nigra, which explains how the SSRI increases dopamine levels. This is the first documented case of an SSRI facilitating the "crack dance."
可卡因使用继发的舞蹈样手足徐动症是一种有充分文献记载的现象，更广为人知的名称是“快克舞蹈症”。它由可卡因使用导致多巴胺过量引发的不受控制的扭动动作组成。我们报告一名32岁男性，他多年来一直使用可卡因，在就诊前四周因抑郁症加重开始服用选择性5-羟色胺再摄取抑制剂（SSRI）帕罗西汀。在过去三年里，他每两周吸食一次可卡因，在此之前从未出现过“快克舞蹈症”。作者进行了全面的文献综述并引用了研究，这些研究表明“快克舞蹈症”与多巴胺过量有关。此前从未有文献记载SSRI与“快克舞蹈症”有关的病例报告。作者提出，SSRI的多巴胺能作用增强降低了“快克舞蹈症”的多巴胺阈值。中缝核与黑质之间存在联系，这解释了SSRI如何增加多巴胺水平。这是首例记录在案的SSRI促成“快克舞蹈症”的病例。
