Eating disorders toxicity

Fluoxetine Highly selective blockade of serotonin transporter (SERT) little effect on norepinephrine transporter (NET) Acute increase of serotonergic synaptic activity slower changes in several signaling pathways and neurotrophic activity Major depression, anxiety disorders panic disorder obsessive-compulsive disorder post-traumatic stress disorder perimenopausal vasomotor symptoms eating disorder (bulimia) Half-lives from 15-75 h oral activity Toxicity Well tolerated but cause sexual dysfunction Interactions Some CYP inhibition (fluoxetine 2D6, 3A4 fluvoxamine 1A2 paroxetine 2D6)... 

Adverse effects include constipation, dry mouth and insonmia which occur in > 10% of users. Less commonly, nausea, tachycardia, palpitations, raised blood pressure, anxiety, sweating and altered taste may occur. Blood pressure should be monitored closely throughout its use (twice weekly in the first 3 months). Contraindications include severe h3q>er-tension, peripheral occlusive arterial or coronary heart disease, cardiac arrhythmia, prostatic hypertrophy and those with severe hepatic or renal impairment. It should not be used to treat obesity of endocrine origin or those with a history of major eating disorder or psychiatric disease. Concomitant use with tricyclic antidepressants should be avoided (CNS toxicity). 

B. Chronic dosing results in cumulative toxicity because of the slow elimination of emetine. Repeated ingestion over time, as in cases of Munchausen by proxy or eating disorders, has been reported to cause myotoxicity with total accumulated doses of 600-1250 mg. Daily ingestion of 90-120 mL of syrup of ipecac for 3 months caused death from cardiomyopathy. 

Toxic effects of ipecac and its alkaloids include gastrointestinal irritation (nausea, vomiting, diarrhea, abdominal pain, etc.), dizziness, hypotension, dyspnea, and tachycardia, among others (Goodman and oilman usd 26th). Side effects can result from abuse by individuals with eating disorders. Cardiac side effects can be severe, for example, myocarditis, cardiomyopathies, and arrhythmias, or even lethal. "... 

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