Fluoxetine Induced Hypotension; a Rare Report

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that exerts its anti-depressive effect by blocking the presynaptic reuptake of the neurotransmitter serotonin (5-HT). Although fluoxetine is usually considered safe for most patients, in the present case report, we describe a young patient with mixed anxiety and depression disorder (MADD) treated with fluoxetine 10 mg/day, who developed hypotension when the dosage was titrated up to 20 mg/day. After discontinuing the use of fluoxetine, the symptoms of hypotension improved. A temporal association and dose-dependent relationship between the hypotension and the use of fluoxetine was observed. To the best of our knowledge, this is the first case report that precisely associates regular doses of fluoxetine with the presence of hypotension. Because some evidence suggests that boosting central serotonergic function lowers blood pressure, it is suggested that a significant effect of fluoxetine on the vasomotor center may be responsible for the reduction of blood pressure. Thus, physicians should be aware of the possible risk of hypotension-induced by fluoxetine and recommend patients discontinuing the drug immediately if complication has occurred.