{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:24:25Z","timestamp":1791872665635,"version":"4.3.4"},"reference-count":333,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Myoclonus is already associated with a wide variety of drugs and systemic conditions. As new components are discovered, more drugs are suspected of causing this disabling abnormal involuntary movement. This systematic review aims to assess the medications associated with drug-induced myoclonus (DIM). Materials and Methods: Two reviewers assessed the PubMed database using the search term \u201cmyoclonus\u201d, without language restriction, for articles published between 1955 and 2024. The medications found were divided into classes and sub-classes, and the subclasses were graded according to their level of evidence. Results: From 12,097 results, 1115 were found to be DIM. The subclasses of medications with level A evidence were intravenous anesthetics (etomidate), cephalosporins (ceftazidime, cefepime), fluoroquinolones (ciprofloxacin), selective serotonin reuptake inhibitors (citalopram, escitalopram, paroxetine, sertraline), tricyclic antidepressant (amitriptyline), glutamate antagonist (amantadine), atypical antipsychotics (clozapine, quetiapine), antiseizure medications (carbamazepine, oxcarbazepine, phenytoin, gabapentin, pregabalin, valproate), pure opioid agonist (fentanyl, morphine), bismuth salts, and mood stabilizers (lithium). The single medication with the highest number of reports was etomidate. Drug-induced asterixis is associated with a specific list of medications. The neurotransmitters likely involved in DIM are serotonin, dopamine, gamma-aminobutyric acid (GABA), and glutamate. Conclusions: DIM may be reversible with management that can include drug discontinuation, dose adjustment, and the prescription of a medication used to treat idiopathic myoclonus. Based on the main clinical constellation of symptoms and pathophysiological mechanisms found in this study, DIM can be categorized into three types: type 1 (serotonin syndrome), type 2 (non-serotonin syndrome), and type 3 (unknown).<\/jats:p>","DOI":"10.3390\/medicina61010131","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T04:42:08Z","timestamp":1736916128000},"page":"131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Drug-Induced Myoclonus: A Systematic Review"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-2177","authenticated-orcid":false,"given":"Jamir Pitton","family":"Rissardo","sequence":"first","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Let\u00edcia","family":"Fornari Caprara","sequence":"additional","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0179-0349","authenticated-orcid":false,"given":"Nidhi","family":"Bhal","sequence":"additional","affiliation":[{"name":"Medicine Department, Jehangir Hospital, Pune 411001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4617-7690","authenticated-orcid":false,"given":"Rishikulya","family":"Repudi","sequence":"additional","affiliation":[{"name":"Medicine Department, Apollo Institute of Medical Sciences and Research, Hyderabad 500072, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Zlatin","sequence":"additional","affiliation":[{"name":"Neuroscience Department, Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian M.","family":"Walker","sequence":"additional","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"},{"name":"Neurology Department, Cooper Medical School of Rowan University, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/S1474-4422(10)70193-9","article-title":"Management of Patients with Myoclonus: Available Therapies and the Need for an Evidence-Based Approach","volume":"9","author":"Dijk","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"327","DOI":"10.4103\/aian.AIAN_1180_20","article-title":"Myoclonus\u2014A Review","volume":"24","author":"Chandarana","year":"2021","journal-title":"Ann. 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