Fluoxetine-Induced Hypoglycaemia in a Patient with Congenital Hyperinsulinism on Lanreotide Therapy

Abstract

Alder Hey Children's Hospital, Clinic of Pediatric Endocrinology, Liverpool, United KingdomDinesh Giri, Victoria Price, Zoe Yung, Mohammed Didi, Senthil SenniappanFluoxetine-Induced Hypoglycaemia in a Patient with Congenital Hyperinsulinism on Lanreotide Therapysubjects as well as in patients with diabetes mellitus (DM). Selective serotonin reuptake inhibitors (SSRIs), in particular fluoxetine, have been associated with hypoglycaemia, reduced awareness of hypoglycaemic episodes, and increased insulin sensitivity in patients with DM (3,4,5,6,7). It is well known that unrecognised and untreated hypoglycaemia can be devastating and can potentially cause neurological damage. Moreover, the hypoglycaemic episodes occurring as a side-effect of these medications can have a negative psychological impact in a chronic condition such as DM and persistent forms of CHI. It is therefore important to be aware of the potential impact of antidepressants on glycaemic control in patients with DM and CHI. Fluoxetine-induced hypoglycaemia has been reported in the literature in adult patients with DM with paucity of literature in the paediatric population. Also, to our knowledge, there are no previous published report of fluoxetine-induced hypoglycaemia in patients with CHI. We report a 15-year-old girl with CHI who developed persistent and recurrent hypoglycaemia secondary to fluoxetine.