Reactions 1405 - 9 Jun 2012

★ SCitalopram

Optic neuritis (first report), mydriasis andgalactorrhoea: case report

A 25-year-old woman developed mydriasis, opticneuritis and galactorrhoea while receiving citalopram.

The woman, who presented in October 2008 withmoderate depression, started receiving citalopram atincreasing doses (20–60mg) [route and frequency notstated] due to ineffectiveness of opipramol. Despite a slightimprovement in her depressive symptoms, she wasadmitted in November because of undulating mood.Zolpidem and mirtazapine were administered. Markedmydriasis was noted within 2 months of citalopramtreatment. She also reported paraesthesias, dysaesthesiasand left sided headaches. A left-sided acute optic neuritiswith paracentral scotoma was diagnosed.

The woman started receiving methylprednisolone. A verysmall patent foramen ovale was observed onechocardiography, and aspirin was recommended.Gynaecological examinations showed left-sided lactation.She also tended towards increased blood glucose levels,which normalised after steroid discontinuation. Ankleoedema developed, but resolved following furosemidetreatment. Her ocular symptoms had resolved aftercitalopram cessation, and bromocriptine was initiated dueto a persistence of her galactorrhoea.

Author comment: "The patient presented is the first casein the literature suffering simultaneously from the trias ofmarked mydriasis, optic neuritis and galactorrhea."Koch HJ, et al. Marked mydriasis and neuritis nervi optici associated withgalactorrhea following citalopram treatment: A case report and discussion. CaseReports in Medicine 2011: [3 pages], No. 191735, 2011. Available from: URL:http://dx.doi.org/10.1155/2011/191735 - Germany 803071813

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of opticneuritis associated with citalopram. The WHO ADR databasecontained 9 reports of optic neuritis associated withcitalopram.

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Reactions 9 Jun 2012 No. 14050114-9954/10/1405-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved