Fluoxetine
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Goldenhar syndrome (first report) in a neonate following in utero exposure: case report Goldenhar syndrome (oculo-auriculo-vertebral spectrum) occurred in a male neonate, whose mother had taken fluoxetine hydrochloride [Prozac] during pregnancy. The neonate’s mother had been receiving fluoxetine 20 mg/day for an unknown indication since before pregnancy, and had maintained the dosage throughout [parental route not stated]. The 2110g, 42cm baby was delivered via caesarean section at 39 weeks, due to decreased fetal movements and abnormal fetal heart tracing. The neonate was cyanotic and severely depressed at birth, and required intubation and ventilation; he also had hypoglycaemia and was transferred to a neonatal ICU. Examination revealed facial asymmetry, right mandibular hypoplasia, bilateral macular hypoplasia and scoliosis. An echocardiogram identified a moderate ventricular septal defect with aneurysmal tissue formation, elevated pulmonary artery pressure, a large patent foramen ovale and mild tricuspid regurgitation [outcome not stated]. Author comment: "Serotonin-binding proteins, expressed in most craniofacial regions at critical times during craniofacial development, may have a buffering capacity that maintains adequate serotonin tissue concentrations over a wide range of serum concentrations. The occurrence of developmental aberrations may nevertheless occur in the presence of particular promoting factors that could act synergistically with SSRIs to create a profound serotonin receptor suppressive state in utero leading to aberrant clinical manifestations of craniofacial development." Farra C, et al. Goldenhar syndrome associated with prenatal maternal Fluoxetine ingestion: Cause or coincidence?. Birth Defects Research Part A: Clinical and 803044635 Molecular Teratology 88: 582-5, No. 7, Jul 2010 - Lebanon
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of Goldenhar syndrome associated with fluoxetine. The WHO ADR database contained no reports of oculoauriculovertebral dysplasia associated with fluoxetine.
0114-9954/10/1329-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 27 Nov 2010 No. 1329
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