{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:28:21Z","timestamp":1790065701756,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,8,10]],"date-time":"2016-08-10T00:00:00Z","timestamp":1470787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Introduction<\/jats:italic>: Fluoxetine is a selective serotonin reuptake inhibitor and long\u2010lived open channel blocker of the acetylcholine receptor, often used in the treatment of slow\u2010channel congenital myasthenic syndromes (CMS). <jats:italic>Methods<\/jats:italic>: We report a 42\u2010year\u2010old woman who had a history of episodic limb weakness that worsened after initiation of fluoxetine for treatment of depression. Genetic testing for CMS revealed a homozygous pathogenic mutation in the rapsyn (<jats:italic>RAPSN<\/jats:italic>) gene (p.Asn88Lys). Electrodiagnostic testing was performed before and 1 month after discontinuation of fluoxetine. <jats:italic>Results<\/jats:italic>: The 2 H<jats:sc>z<\/jats:sc> repetitive nerve stimulation of the fibular and spinal accessory nerves showed a baseline decrement of 36% and 14%, respectively. One month after discontinuing fluoxetine, the spinal accessory nerve decrement was no longer present, and the decrement in the fibular nerve was improved at 17%. <jats:italic>Conclusions<\/jats:italic>: This case demonstrates worsening of both clinical and electrophysiologic findings in a patient with CMS secondary to a <jats:italic>RAPSN<\/jats:italic> mutation treated with fluoxetine. <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>55<\/jats:bold>: 131\u2013135, 2017<\/jats:p>","DOI":"10.1002\/mus.25244","type":"journal-article","created":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T08:39:55Z","timestamp":1468226395000},"page":"131-135","source":"Crossref","is-referenced-by-count":10,"title":["Rapsyn congenital myasthenic syndrome worsened by fluoxetine"],"prefix":"10.1002","volume":"55","author":[{"given":"Amy C.","family":"Visser","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic 200 First Street SW Rochester Minnesota 55905 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruple S.","family":"Laughlin","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic 200 First Street SW Rochester Minnesota 55905 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Litchy","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic 200 First Street SW Rochester Minnesota 55905 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo E.","family":"Benarroch","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic 200 First Street SW Rochester Minnesota 55905 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Milone","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic 200 First Street SW Rochester Minnesota 55905 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70201-7"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181ae7cbc"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(95)01349-0"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001756-199806010-00044"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000061483.11417.1B"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2009.06.015"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/339465"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10433"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000072262.14931.80"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.40.6.e81"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000085865.55513.AE"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2004.03.005"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20241"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.25244","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.25244","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.25244","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.25244","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.25244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T01:10:04Z","timestamp":1694135404000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.25244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,10]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1002\/mus.25244"],"URL":"https:\/\/doi.org\/10.1002\/mus.25244","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,10]]}}}