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Duloxetine-related posterior reversible encephalopathy syndrome: A case report
Nathalie Zappella1, François Perier, Fernando Pico
1Intensive Care Unit Neurology and Stroke Department Pharmacology Unit Emergency Department, Centre Hospitalier de Versailles - Site André Mignot, rue de Versailles, Le Chesnay cedex Paris Descartes University, Sorbonne Paris Cité-Medical School INSERM U970, Paris Cardiovascular Research Center, Paris, France.
Background:
Posterior reversible encephalopathy syndrome (PRES) has well-established links with several drugs. Whether a link also exists with serotonin-norepinephrine reuptake inhibitor such as duloxetine is unclear.
Methods:
We report on a patient who developed PRES with a coma and myoclonus related to hypertensive encephalopathy a few days after starting duloxetine treatment. Magnetic resonance imaging was performed and catecholamine metabolites assayed.
Results:
The patient achieved a full recovery after aggressive antihypertensive therapy and intravenous anticonvulsant therapy.
Conclusions:
The clinical history, blood and urinary catecholamine and serotonin levels, and response to treatment strongly suggest that PRES was induced by duloxetine. Duloxetine should be added to the list of causes of PRES.
