Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine

Background. Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been re...

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Main Authors: Matthew Herrmann, Prissilla Xu, Antonio Liu
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2017/5415243
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author Matthew Herrmann
Prissilla Xu
Antonio Liu
author_facet Matthew Herrmann
Prissilla Xu
Antonio Liu
author_sort Matthew Herrmann
collection DOAJ
description Background. Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act. Results. Autopsy was performed at the Los Angeles County Medical Examiner’s Office of a female with no evidence of traumatic injury. Toxicological analysis revealed lethal levels of fluoxetine, toxic levels of diphenhydramine, and multiple other coingested substances at nontoxic levels. Neuropathological examination of the brain and spinal cord revealed no evidence of Guillain-Barre paralysis. Conclusions. Lethal levels of fluoxetine and multiple potential drug-to-drug interactions in our patient likely contributed to her unique signs and symptoms. This is the first case reporting neurologic signs and symptoms consisting of rapid onset ascending sensorimotor paralysis, hearing loss, respiratory failure, cardiac arrest, and death in a patient with lethal levels of fluoxetine.
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spelling doaj-art-ee76b8fc263c473eb56c67aee785171e2025-08-20T03:20:40ZengWileyCase Reports in Neurological Medicine2090-66682090-66762017-01-01201710.1155/2017/54152435415243Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of FluoxetineMatthew Herrmann0Prissilla Xu1Antonio Liu2White Memorial Medical Center Department of Internal Medicine, Los Angeles, CA, USAWhite Memorial Medical Center Department of Internal Medicine, Los Angeles, CA, USAWhite Memorial Medical Center Department of Internal Medicine, Los Angeles, CA, USABackground. Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act. Results. Autopsy was performed at the Los Angeles County Medical Examiner’s Office of a female with no evidence of traumatic injury. Toxicological analysis revealed lethal levels of fluoxetine, toxic levels of diphenhydramine, and multiple other coingested substances at nontoxic levels. Neuropathological examination of the brain and spinal cord revealed no evidence of Guillain-Barre paralysis. Conclusions. Lethal levels of fluoxetine and multiple potential drug-to-drug interactions in our patient likely contributed to her unique signs and symptoms. This is the first case reporting neurologic signs and symptoms consisting of rapid onset ascending sensorimotor paralysis, hearing loss, respiratory failure, cardiac arrest, and death in a patient with lethal levels of fluoxetine.http://dx.doi.org/10.1155/2017/5415243
spellingShingle Matthew Herrmann
Prissilla Xu
Antonio Liu
Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
Case Reports in Neurological Medicine
title Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
title_full Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
title_fullStr Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
title_full_unstemmed Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
title_short Rapid Ascending Sensorimotor Paralysis, Hearing Loss, and Fatal Arrhythmia in a Multimorbid Patient due to an Accidental Overdose of Fluoxetine
title_sort rapid ascending sensorimotor paralysis hearing loss and fatal arrhythmia in a multimorbid patient due to an accidental overdose of fluoxetine
url http://dx.doi.org/10.1155/2017/5415243
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