Treatment of Raynaud's phenomenon with escitalopram.

Serotonin has been shown to play a significant role in diseases related to vascular dysregulation like Raynaud’s phenomenon (Hollenberg, 1988), erythromelalgia (Rudikoff and Jaffe, 1997),migraine (Bonvento et al., 1991) and perimenopausal hot flushes (Berendsen, 2000). In recent years there have been several reports on the efficacy of the selective serotonin reuptake inhibitors (SSRIs) fluoxetine (Coleiro et al., 2001; Jaffe, 1995; Rey et al., 2003) and sertraline (Rey et al., 2003) in the treatment of Raynaud’s phenomenon. Whereas erythromelalgia too has been reported to respond to SSRIs and to the serotonergic effect of venlafaxine (Rudikoff and Jaffe, 1997), it can also occur as a complication of the treatment of Raynaud’s phenomenon with fluoxetine and sertraline (Rey et al., 2003). These few reports show that there is consistent evidence for SSRIs having effects on vascular responses of the extremities but that there is, at the same time, an important variability of the effects of each substance. We report what we believe to be the first case of treatment of Raynaud’s phenomenon with escitalopram.