Letters to the editor
Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome?
| The first 150 words of the full text of this article appear below. |
EDITOR
We would like to comment on
the article "Neonatal paroxetine withdrawal syndrome" in the March
2001 issue of the journal.1 The authors describe what they
have called "neonatal paroxetine withdrawal syndrome". However the
syndrome reported in the 4 neonates appears to be more consistent with
serotonin toxicity, rather than withdrawal of paroxetine.
The literature to date contains one large series,2 two similar case reports with fluoxetine3 4 and two case reports with paroxetine.5 6
In the fluoxetine cases the syndrome was not described as a withdrawal
phenomenon. In the first, a neonate born to a mother on fluoxetine had
jitteriness, irritability, tachypnoea, temperature instability,
tremors, increased muscle tone, and a hyperactive Moro
reflex.3 All except the last of these are clinical
features seen in serotonin toxicity in adults using selective serotonin uptake inhibitors (SSRIs) therapeutically or in
overdose.7 8 The neonate in this case had fluoxetine
levels that were measurable initially and which
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