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: Ann Pharmacother. 2004 Apr;38(4):617-20. Epub 2004 Feb 13. Related Articles, Links
Click here to read 
Transient ischemic attack reported with paroxetine use.

Manos GH, Wechsler SM.

Department of Psychiatry, Naval Medical Center Portsmouth, Portsmouth, VA 23708-2197, USA.

OBJECTIVE: To report the occurrence of a transient ischemic attack (TIA) temporally related to the initiation of paroxetine. CASE SUMMARY: A 57-year-old white man with a history of intermittent atrial fibrillation and hypercholesterolemia developed slurred speech and a facial droop 3 days after starting paroxetine. He was diagnosed with a TIA, hospitalized, and given anticoagulation treatment. The presenting symptoms resolved, but recurred when paroxetine was restarted 2 days later. DISCUSSION: Platelets secrete serotonin, which mediates vasoconstriction through stimulation of 5-HT2a receptors. This is counterbalanced by the release of the vasodilator nitric oxide upon serotonin stimulation of endothelial 5-HT1 receptors. In conditions such as atherosclerosis, the damage to the endothelium leads to a greater vasoconstrictive response. Paroxetine has been reported to weakly inhibit norepinephrine reuptake and nitric oxide production in addition to increasing serotonergic activity, potentially compounding the vasoconstrictive response. An objective causality assessment revealed that the TIA was probably an adverse event resulting from use of paroxetine. CONCLUSIONS: Use of paroxetine and other selective serotonin-reuptake inhibitors may result in changes of the vasculature and subsequent ischemic events in predisposed patients.

Publication Types:
  • Case Reports

PMID: 14966255 [PubMed - indexed for MEDLINE]