Entrez PubMed Nucleotide Protein Genome Structure OMIM PMC Journals Books
 Search for
  Limits Preview/Index History Clipboard Details    
spacer gif About Entrez

Text Version

Entrez PubMed
Help | FAQ

PubMed Services
Journals Database
MeSH Database
Single Citation Matcher
Batch Citation Matcher
Clinical Queries

Related Resources
Order Documents
NLM Gateway
Consumer Health
Clinical Alerts
PubMed Central


1: J Psychopharmacol. 1999;13(3):313-7. Related Articles, Links

Comment in: Click here to read 
Postoperative delirium indicating an adverse drug interaction involving the selective serotonin reuptake inhibitor, paroxetine?

Stanford BJ, Stanford SC.

Department of Anaesthetics, St George's Hospital, London, UK.

We report a postoperative delirium expressed by a 49-year-old female patient during recovery from anaesthesia. Prominent features of the delirium, which lasted for nearly 2 days, included agitation, confusion, uncontrolled limb movements, abnormal ocular function, hypertension, pyrexia, brisk reflexes, ankle clonus and raised creatine kinase. The delirium did not respond to naloxone, diazepam or flumazenil. The patient had not been prescribed neuroleptics but, before surgery, she had been taking the selective serotonin reuptake inhibitor, paroxetine, to relieve her depression. During surgery, she was given morphine, which increases release of the neurotransmitter, serotonin, and ondansetron, which blunts neuronal release of dopamine. Although there is no clear explanation for the delirium, it had many features in common with problems associated with paroxetine withdrawal, the serotonin syndrome and the malignant neuroleptic syndrome. We offer several alternative explanations for this event, all of which rest on disruption of serotonergic and/or dopaminergic transmission and which could also involve inhibition by paroxetine of the P450 enzyme, CYP2D6, which metabolizes ondansetron.

Publication Types:
  • Case Reports

PMID: 10512094 [PubMed - indexed for MEDLINE]