Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) treatment for Isaacs syndrome with depression.

摘要

Serotonin- norepinephrine- reuptake inhibitor (SNRI) has been widely used in depression and pain disorders (Goldstein et al., 2004). Duloxetine, one of the commonly prescribed SNRIs, has also been reported to be effective not only for somatic and depressive symptoms in depression but also for pain not associate with depression (Shelton et al., 2007). In fact, duloxetine has been approved by FDA for the treatment of diabetic neuropathic pain (Wong et al., 2007) and fibromyalgia (Arnold, 2007). Pain is a devastating symptom in Isaacs syndrome, which is a rare neuromuscular disorder with continuous signaling of peripheral nerve fibers, as along with symptoms of progressive muscle stiffness and severe pain (Isaacs, 1967; NINDS, 2007). The characteristic symptoms of Isaacs syndrome include involuntary twitchings (myokymia), muscle stiffness, muscle pain, and electromyogram (EMG) of limbs often reveals myokymic discharges. (Isaacs, 1967; NINDS, 2007). To our knowledge, SNRI has not yet been reported in treating painful and depressive symptoms of Isaacs Syndrome. Here we report a patient with Isaacs syndrome and major depressive episode who responded well to duloxetine in the improvement of mood and painful symptoms.