Abstract

A 39-year-oldbegun on fluoxetine (20 mg p0 q a.m.) for symptoms of depression. After the initial doses the patient experienced a mildsleepiness.was increasedover thefor the currently controversial Ritalin and Dexedrine (dextroamphetamine sulfate) treatments. DOREEN A. SABALESKY, M.D. Irvine, California tuteblind right sualin his eyelid.of histo beeye, withptosis of his left eye’s vihemianop-fields revealeda lateralsia. The remainderexam was intact.of his neurologicalto 60 mgdose,p0 q day. Approxiweeks after the increasebegan to suffer severeRoutine laboratory testing on admission indicated a moderate anemia, andI.atedaytime somnolence. Although the patient complained about the impairmentin his crease daily activities, he reported to think clearly an inin his capacityof Craniopharyngioma Lifeand to organize his thoughts for the first time in his life. Fluoxetine was discontinued after five hypersomnolence, months due to the to which the patientSIR: Craniopharyngioma is a congenital tumor which most frequently presents in childhood. It is not uncommon, however, for craniopharyngioma to first manifest inlow fasting glucose at 34 mg/dl (65115). Electrolytes, liver function tests, VDRL, B12, and folate levels were normal.Further tus revealed ism, with testing of endocrinologic evidence of hypothyroida free T4 of 0.7 ng/dlACTH of (0.2-5.4). 116sta-(0.8-2.0)did not developa tolerance.The patient had no history of psychiatric hospitalizations. He had seen