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Wednesday November 6 1:02 PM EST

Serotonin Syndrome In Prozac Users

NEW YORK (Reuters) -- Health experts are worried that people who take Prozac
and similar drugs for depression may encounter serious side effects if they
are also taking certain other medications.

Their report in the November issue of the Annals of Emergency Medicine says
the increasing popularity of "selective serotonin reuptake inhibitors
(SSRIs)," such as Prozac, is leading to more cases of potentially fatal
"serotonin syndrome" due to drug interactions and overdoses.

"Because the number of prescriptions being written for SSRIs is rising
rapidly, emergency physicians are going to see the serotonin syndrome a lot
more frequently," says University of Pittsburgh emergency doctor Dr. Thomas
G. Martin. "We want people, especially the elderly who are likely to be
taking a variety of medications, to be aware that something as subtle as
increased confusion, unusual behavior, or agitation may be the first sign of
serotonin syndrome. So, it's important that your doctor knows what drugs you
take."

Serotonin syndrome has a variety of symptoms -- hallucinations, confusion,
fluctuating blood pressure, seizures, high temperatures, stiffness, and
irregular heart beats.

People taking SSRIs can develop the syndrome when they take illegal drugs
such as LSD, cocaine, or "ecstasy" (MDMA). Also at risk are people taking
Demerol -- a commonly prescribed pain medication, and imipramine (Tofranil),
another antidepressant. Martin notes that the most severe -- even fatal --
drug interactions can occur from mixing SSRIs with older antidepressants
such as Nardil.

"These new antidepressants (SSRIs) are helpful to many patients when used
correctly," says Martin. But, even though these drugs have fewer side
effects than their predecessors, they can be dangerous when combined with
other drugs."

SOURCE: Annals of Emergency Medicine (1996;28(5):520-525)






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