Pseudophaeochromocytoma in parkinsonian patient treated with fluoxetine plus selegiline

Jl, Montastruc; Chamontin, B.; Senard, Jean‐Michel; Tran, Marie-Antoinette; Rascol, O.; Llau, M E; Rascol, A

doi:10.1016/0140-6736(93)90313-6

Cited by 59 publications

(23 citation statements)

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“…6 It was similar to the doses described in the three reports of a possible fluoxetine-selegiline interaction. [8][9][10] A limitation of this retrospective study is the absence of plasma levels of fluoxetine or its metabolite, norfluoxetine. Thus true pharmacokinetic interaction cannot be ruled in or out.…”

Section: Discussionmentioning

confidence: 99%

“…The following information THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES was obtained: patient age, sex, years of PD, daily dose of and 13 males. The mean duration of illness was 7.35 years levodopa, use of other antiparkinsonian medications, dates of (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The mean dose of fluoxetine was 24.56 mg (range use of selegiline, dates of use of fluoxetine, reasons for discon-5-40 mg).…”

Section: Methodsmentioning

confidence: 99%

“…9 In a third report, severe hypertension was produced with associated elevation in plasma and urinary catecholamines. 10 These reversed within two days of stopping both drugs. Because there is a significant amount of depression in patients with PD," probably due to reduced serotonin, 12 it would be helpful to know if these two medications can be used together safely.…”

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confidence: 99%

“…Although there is little convincing evidence that the combination of fluoxetine-selegiline results in adverse effects, three recent publications suggest a possible interaction between these medications. 8 " 10 In the first report, the combination produced mania in one patient and hypertension in another. 8 In another case report, ataxia was felt to be due to an interaction between the two medications.…”

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Fluoxetine and Selegiline – Lack of Significant Interaction

1994

Can. j. neurol. sci.

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The use of the combination of fluoxetine, an anti-depressant serotonin uptake inhibitor, and selegiline, a monoamine oxidase -B inhibitor, was reviewed in a large population of patients with Parkinson's disease. All records were reviewed from a Parkinson's disease clinic to determine how many patients were treated simultaneously with selegiline and fluoxetine. Patient characteristics, duration and dose of treatment, side effects and reasons for discontinuation were noted. Twenty-three patients received both medications at the same time. No additional side effects were noted with the combination therapy that had not already been reported with each medication alone. No serious side effects were found. In this clinic population, fluoxetine and selegiline were used in combination without major side effects, but further observation is warranted.Resume: Fluoxetine et selegiline -absence d'interaction significative. Nous avons revu I'utilisation combined de la fluoxetine, un anti-depresseur inhibant la captation de la serotonine, et de la selegiline, un inhibiteur de la (MAO)-B, dans une grande population de patients atteints de la maladie de Parkinson. Tous les dossiers d'une clinique de Parkinson ont ete revises pour determiner combien de patients avaient ete trails simultan^ment par la selegiline et la fluoxetine. Les caracteristiques des patients, la duree du traitement et la dose, les effets secondaires et les raisons de cessation du traitement ont ete relev6s. Vingt-trois patients ont recu les deux medicaments en meme temps. Aucun effet secondaire, qui n'avait pas et6 rapportd avec chacun des medicaments administre' en monotheYapie, n'a ete note avec la therapie combinee. Aucun effet secondaire grave n'a 6t6 rapporte. Dans la population de cette clinique, la fluoxetine et la selegiline ont ete utilisees en combinaison, sans effet secondaire majeur. Cependant d'autres observations sont requises pour certifier cette absence d'interaction significative.Can. J. Neurol. Sci. 1994; 21: 259-261 Fluoxetine and selegiline are two recently released medications. The anti-depressant fluoxetine is a serotonin uptake inhibitor. 1 Selegiline, used predominantly for enhancing the effects of levodopa in Parkinson's disease (PD), is a monoamine oxidase (MAO)-B inhibitor, 2 when used in the recommended dose of 10 mg per day. If this dose is exceeded, it is no longer a selective MAO-B inhibitor. 3 As serotonin is metabolized by MAO-A, 4 blocking this enzyme enhances serotonin's action. An interaction between nonspecific MAO inhibitors and fluoxetine can produce a "serotonin syndrome" with tremor, agitation, restlessness, confusion, hypomania, hypertension and diarrhea. 5 The risk varies with the type of MAO inhibitor, 6 and in some instances the two types of medication can be used in combination quite safely. 7 The current manufacturer's recommendation is that fluoxetine (Dista Products) should not be taken with any MAO inhibitor. Although there is little convincing evidence that the combination of fluoxetine-selegiline...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Fluoxetine and Selegiline – Lack of Significant Interaction

1994

Can. j. neurol. sci.

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“…[7][8][9][10][11] The use of SSRIs in PD is further limited by the risk of causing a "serotonin syndrome" in patients treated concurrently with SSRIs and the mono-amino-oxidase inhibitors, including selegiline. [12][13][14] S-Adenosyl-methionine (SAM) is a molecule present in all eukaryotic cells, and it is synthesized from methionine and ATP. SAM participates as the methyl group donor to a number of metabolic events, including the cathecol-O-methyl-transferase (COMT)-dependent metabolism of cathecholamines, the synthesis of phosphatidylcholine and creatine, and the methylation of phospholipids, proteins, and nucleosides.…”

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confidence: 99%