Generalized Myoclonus in an Elderly Patient on Risperidone: A Rare but Important Adverse Effect.

Abstract

Objective: Drug-induced myoclonus is a rare adverse effect associated with several drug classes, including antipsychotics. This case report describes a patient who developed generalized myoclonic jerks while on long-term risperidone therapy, in the context of concomitant sertraline use, without fulfilling clinical criteria for serotonin syndrome. Case Presentation: We present a 73-year-old male patient with a history of cerebrovascular disease and behavioral symptoms treated with sertraline and risperidone. The patient developed sudden, generalized myoclonic movements. Neurological examination and imaging studies excluded acute structural pathology and metabolic or infectious causes. Serotonin syndrome was ruled out based on clinical findings. The myoclonus resolved rapidly after discontinuation of risperidone, without any specific symptomatic treatment, suggesting a potential drug-related mechanism. Conclusion: This case highlights the importance of recognizing antipsychotic-related myoclonus as a potentially reversible condition. Clinicians should consider drug-induced myoclonus in the differential diagnosis and pay special attention to the risks posed by polypharmacy involving psychotropic agents.