Reactions 1680, p277 - 2 Dec 2017 Lethargy and confusion: case report A 78-year-old man developed lethargy and confusion following concomitant administration of phenytoin and sertraline [not all indications stated]. The man, who had a history of depression and seizures, was receiving oral phenytoin 100mg four times daily for the past five years along with citalopram and other medications. Citalopram was switched to oral sertraline 100mg due to worsening of depression symptoms, on 04 January 2016. In March 2016, he presented with lethargy and confusion. His friends reported that he was increasingly withdrawn, not engaging in conversation, lethargic, and delayed in responses. His examinations showed slow responses to commands and questions. Psychiatric consultation advised lowering of sertraline dose with intention of discontinuing the medication. His serum phenytoin level was elevated, which was normal prior to the initiation of sertraline. Phenytoin was discontinued and the man’s serum phenytoin level returned to normal. Subsequently, sertraline was also discontinued. Afterwards, his cognitive function returned to baseline. Author comment: "In this case, the medical team concluded that the cause of the patient’s lethargy and confusion was a drug interaction between sertraline and phenytoin." Nathan KT, et al. Sertraline and phenytoin drug interaction in a geriatric patient. Annals of Long-Term Care 25: 46-48, No. 5, Oct 2017. Available from: URL: http://doi.org/10.25270/altc.2017.10.e00001 - USA 803285023 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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