Clinical Practice and Cases in Emergency Medicine

Introduction: Duloxetine, a serotonin-norepinephrine reuptake inhibitor, has been associated with extrapyramidal symptoms and tardive syndromes; however, such adverse reactions are rare and remain sparsely documented, particularly in the setting of non-psychiatric use.

Case Report: A young, healthy, active-duty military service member developed acute extrapyramidal symptoms—restlessness, dystonic movements, and acute dystonia—shortly after initiating duloxetine for postsurgical neuropathic pain. 

Conclusion: This case highlights the need for vigilance regarding movement disorders in patients prescribed duloxetine, even in the absence of psychiatric comorbidity or antipsychotic exposure.