Experts in Prescription Drug Withdrawal
Scenario 1
A 35-year-old white woman was treated with paroxetine (Paxil) for panic disorder. She developed unrelated hypertension, and was prescribed 50 mg daily of extended-release metoprolol (Toprol XL) by her physician. Within a few days the patient became symptomatically orthostatic and was admitted to the emergency department. Metoprolol, which is metabolized solely by CYP2D6, was present in higher serum levels because of the use of paroxetine.
