title: Case report of a syncopal episode associated with fluoxetine.
abstract: OBJECTIVE
  To report a syncopal episode associated with fluoxetine in a young, relatively healthy man.
  
  
  METHODS
  Single case report.
  
  
  METHODS
  585-bed private hospital.
  
  
  METHODS
  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 episode.
authors.affiliation: St. Anthony Hospital, Oklahoma City, OK 73101.
authors.forename: L E
authors.initials: LE
authors.lastname: McAnally
authors.forename: K R
authors.initials: KR
authors.lastname: Threlkeld
authors.forename: C A
authors.initials: CA
authors.lastname: Dreyling
mesh_terms: D000328:Adult; D004562:Electrocardiography; D004569:Electroencephalography; D005473:Fluoxetine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D012640:Seizures / Q000175:diagnosis; D013575:Syncope / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D005473:Fluoxetine