Transient, Paroxysmal, Shock-Like Paresthesias Associated With Paroxetine Initiation

Letter to the Editor

Sir: We report three cases of transient, paroxysmal, shocklike paresthesias associated with the initiation of paroxetine treatment.

Case 1. Ms. A, a 25-year-old Hispanic woman diagnosed by DSM-IV criteria with a major depressive episode and associated anxiety, was placed on paroxetine 20 mg/day. For the first 3 days, shortly after taking her morning 20-mg dose, she experienced facial paresthesias of a mild, electric-shock-like nature that were also associated with the subjective sense of facial twitching. Each episode lasted approximately 5 minutes.