A serotonin-like
syndrome has developed in several patients taking
SSRIs with dextromethorphan, although in many of these cases the use of other drugs with serotonergic actions may have contributed. Hallucinations have been reported in one patient taking fluoxetine with
dextromethorphan. Paroxetine and fluoxetine mark- edly inhibit the
metabolism of
dextromethorphan.
It would seem prudent for patients taking any SSRI to be cautious if using dextromethorphan-containing products because
serotonin syndrome, can be serious. The pharmacokinetic interaction between
dextromethorphan paroxetine and fluoxetine may increase the risks of this effect.