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Memory Loss in a Patient Treated with Fluoxetine

Clinical Pharmacy Specialist, Ambulatory Services, Good Samaritan Regional Medical Center, Corvallis, OR

Robert M Burton, MD PhD

Physician in Internal Medicine, Samaritan Internal Medicine, Good Samaritan Regional Medical Center

Cecilia A Keller, MD

Board-Certified Adult Neurologist, Neurology Department, The Corvallis Clinic, Corvallis

Reprints: Jacqueline D Joss PharmD, 3615 NW Samaritan Dr., Ste. 103, Corvallis, OR 97330-3763, FAX 541/768-6662, jjoss{at}samhealth.org

OBJECTIVE: To report a case of severe memory loss in an elderly patient after initiation of fluoxetine.

CASE SUMMARY: An 87-year-old white woman was started on fluoxetine for depression, and the dose was titrated to 20 mg/d. She developed progressive memory loss over the next 6 weeks for which she ultimately was hospitalized. Other potential causes for her memory loss were ruled out. After fluoxetine was discontinued, the patient's memory improved significantly over the next 2 months. An objective causality assessment indicated a possible relationship between the memory loss and fluoxetine in this patient.

DISCUSSION: Our report documents a case of severe reversible memory deterioration after initiating fluoxetine. Fluoxetine has a favorable adverse effect profile when compared with older classes of antidepressants. Postmarketing studies and isolated case reports, however, suggest that fluoxetine may harm memory in some patients. Some selective serotonin-reuptake inhibitors (SSRIs) appear to cause memory loss more frequently than others.

CONCLUSIONS: Clinicians should be aware of the possible effects of fluoxetine (and possibly other SSRIs) on memory.

Key Words: fluoxetine, memory loss, selective serotonin-reuptake inhibitors

Published Online, October 29, 2003. www.theannals.com, DOI 10.1345/aph.1D154

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