Propofol Fluoxetine

Armstror TSH, Martin PD. Propofol, fluoxetine and spcxitaneous movement Anaesfftesia (1997) 52,809-10. 

A 72-year-old woman with a symptomatic hiatus hernia, osteoarthritis, and Alzheimer s disease was taking fluoxetine 20mg/day, donepezil hydrochloride 10 mg/ day, nimesulide 12.5mg/day, and omeprazole 20 mg/ day (288). There still was no twitch response to peripheral nerve stimulation 20 minutes after rapid-sequence induction of anesthesia with propofol 2.5mg/kg and suxamethonium 1 mg/kg. She then gradually developed a weak twitch response, and 50 minutes after induction of anesthesia four twitches with a fade were elicited by train-of-four stimulation. No additional medication was given and after the end of the procedure 10 minutes later she was extubated uneventfully. She refused further blood testing and so her plasma cholinesterase activity at that time is not known. However, her anesthetic notes from a previous operation did not reveal any problems with prolonged paralysis after suxamethonium. 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

One patient had a seizure when she was given methohexital while taking paroxetine. Spontaneous movements have been seen in two patients taking fluoxetine when they were anaesthetised with propofol. 

Two women in their mid-twenties, who had been taking fluoxetine 20 mg daily for 4 to 6 months, had pronounced involuntary upper limb movements lasting 20 to 30 seeonds immediately after anaesthetie induetion with 180 mg of propofol (2 to 2.5 mg/kg). The movements eeased spontaneously and the rest of the anaesthesia and surgery were uneventful. Neither had any history of epilepsy or movement disorders. It is not elear whether this was an interaetion between propofol and fluoxetine or just a rare (but previously reported) reaetion to propofol. ... 

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