Tingling in tongue due to alprazolam and paroxetine-induced hypergabaergic activity

Year 2019, Volume: 5 Issue: 2, 410 - 412, 04.03.2019

Barış Önen Ünsalver , Alper Evrensel , Mehmet Emin Ceylan

https://doi.org/10.18621/eurj.402017

Cited By: 1

Abstract

Paroxetine is a commonly used serotonin-reuptake
inhibitor for the treatment of various psychiatric disorders. Available
literature is sparse with cases of paresthesia that occur during withdrawal of
paroxetine, there are fewer reports of paresthesia during the initiation. Here
we report a case of panic disorder who experienced tingling of the tongue
during the initiation phase of paroxetine, and whose paresthesia resolved only
after the withdrawal of the drug. When paroxetine was introduced, the patient
was already on alprazolam monotherapy. Therefore, the previously activated
GABAergic state with alprazolam was probably further augmented with paroxetine.
We suggest that the serotonin receptor supersensitivity related to panic
disorder might have been a vulnerability factor for paresthesia, and the
hypergabaergic state caused by alprazolam and paroxetine combination made the
paresthesia evident in our case. This is the first report of a case with
paresthesia in a combination of alprazolam and paroxetine. We might suggest
that in patients who develop paresthesia during psychotropic use, the
clinician's first step might be to just decrease the dosage of the drugs before
further clinical and laboratory evaluation of the patient for paresthesia. 

Keywords

paresthesia, paroxetine, alprazolam, hypergabaergic state

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