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Case report of a syncopal episode
associated with fluoxetine.
McAnally LE, Threlkeld
KR, Dreyling CA.
St. Anthony Hospital, Oklahoma City, OK
OBJECTIVE: To report a syncopal episode associated with
fluoxetine in a young, relatively healthy man. DESIGN: Single case
report. SETTING: 585-bed private hospital. PATIENT: A 30-year-old man
with hypertension, esophageal ulcers, and syncope of recent onset.
RESULTS: Fluoxetine was started six weeks prior to the syncopal episode
in this patient, and is the medication most temporally associated with
the event. Because the patient had a normal neurologic examination and
electroencephalogram, but an abnormal electrocardiogram on admission and
one month after discharge, the syncopal episode was most likely caused
by cardiovascular effects of fluoxetine. CONCLUSIONS: Fluoxetine has
been reported to cause cardiac conduction abnormalities in otherwise
normal individuals. Bradycardia secondary to a direct effect of
fluoxetine, or to a drug interaction among fluoxetine, ranitidine, and
enalapril is the most likely explanation for this patient's syncopal
PMID: 1421672 [PubMed - indexed for