Hypoglycemia associated with the use of fluoxetine.

HYPOGLYCEMIA HAS many causes in patients who do not have diabetes mellitus, in contrast to patients with diabetes mellitus, in whom hypoglycemia is most often due to the use of insulin or oral hypoglycemic agents. We report a case of symptomatic hypoglycemia associated with fluoxetine use in a patient with non-insulin-dependent diabetes mellitus. Symptoms of sweating, tremor, or anxiety occur in 10% or more of patients taking fluoxetinel2 and can eas-ily be confused with hypoglycemia that occurs in diabetic patients.3 In the case reported here, symptomatic hypoglycemia was associated with increased blood insulin levels during a 72-hour fast while the patient was taking fluoxetine. This case emphasizes the importance in evaluating the occurrence of hypoglycemia of discontinuing all nonessential medications during a 72-hour fast.