Selective serotonin reuptake inhibitors affect structure, function and metabolism of skeletal muscle: A systematic review

Selective Serotonin Reuptake Inhibitors (SSRIs) may have side effects, such as stiffness, tremors and altered tonic activity, as well as an increased risk of developing insulin resistance and diabetes mellitus. However, little is known about the structural, functional and metabolic changes of skeletal muscle after administration of SSRIs. The aim of this systematic review was to explore and discuss the effects of SSRIs on skeletal muscle properties described in human and rodent studies. A systematic search of PUBMED, SCOPUS, and WEB OF SCIENCE was performed. The inclusion criteria were intervention studies in humans and rodents that analysed the effects of SSRIs on skeletal muscle properties. The research found a total of six human studies, including two randomized controlled trials, one non-randomized controlled trial, one uncontrolled before-after study and two case reports, and six preclinical studies in rodents. Overall, the studies in humans and rodents showed altered electrical activity in skeletal muscle function, assessed through electromyography (EMG) and needle EMG in response to chronic treatment or local injection with SSRIs. In addition, rodent studies reported that SSRIs may exert effects on muscle weight, the number of myocytes and the cross-sectional area of skeletal muscle fibre. The results showed effects in energy metabolism associated with chronic SSRI use, reporting altered levels of glycogen synthase activity, acetyl-CoA carboxylase phosphorylation, citrate synthase activity, and protein kinase B Ser phosphorylation. Moreover, changes in insulin signalling and glucose uptake were documented. In this context, we concluded based on human and rodent studies that SSRIs affect electrical muscle activity, structural properties and energy metabolism in skeletal muscle tissue. However, these changes varied according to pre-existing metabolic and functional conditions in the rodents and humans.