{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:16:38Z","timestamp":1790982998235,"version":"4.1.0"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Am Psychiatr Nurses Assoc"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe a case of biopsy-confirmed lymphocytic microscopic colitis (MC) temporally associated with paroxetine (Paxil) therapy and to highlight psychiatric nursing implications for monitoring serotonergic adverse effects across the brain\u2013gut interface.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This case report was developed using clinical history, diagnostic findings, treatment course, and relevant literature on selective serotonin reuptake inhibitors, MC, and serotonergic signaling in gastrointestinal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 27-year-old male with generalized anxiety disorder, panic disorder, agoraphobia, and irritable bowel syndrome developed chronic watery diarrhea, abdominal pain, bowel urgency, and one episode of fecal incontinence while receiving paroxetine, which had previously produced sustained psychiatric remission. Differential considerations included an irritable bowel syndrome flare, infectious diarrhea, inflammatory bowel disease, medication-associated diarrhea, and medication-associated microscopic colitis. Colonoscopy with biopsy confirmed lymphocytic MC. Paroxetine was discontinued, and the patient was treated with budesonide (Entocort EC) and adjunctive gastrointestinal therapies, leading to resolution of gastrointestinal symptoms. After recurrence of anxiety and panic symptoms and poor tolerability or inadequate response to alternative psychotropic medications, paroxetine extended-release was cautiously reintroduced with interdisciplinary monitoring. Gastrointestinal symptoms did not recur during the 1-year follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This case illustrates the importance of psychiatric nursing vigilance for persistent gastrointestinal symptoms in patients receiving serotonergic antidepressants. Recognition of possible medication-associated MC may support timely referral, interdisciplinary collaboration, and individualized psychopharmacologic decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10783903261477364","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:50:30Z","timestamp":1787313030000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Lymphocytic Microscopic Colitis Associated with Paroxetine: A Psychiatric Nursing Case Report"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6479-3195","authenticated-orcid":false,"given":"Matthew","family":"Milewski","sequence":"first","affiliation":[{"name":"Rutgers University School of Nursing, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"DeGeorge K. C. Grover M. Streeter G. S. (2022). Generalized anxiety disorder and panic disorder in adults. American Family Physician 106(2) 157\u2013164. https:\/\/pubmed.ncbi.nlm.nih.gov\/35977134\/"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Johnson C.F. MacGillivray S. A. McCowan C. (2022). Dose-response effects of selective serotonin reuptake inhibitor monotherapy for the treatment of depression: Systematic review of reviews and meta-narrative synthesis. BMJ Medicine 1(1) e000017. https:\/\/pubmed.ncbi.nlm.nih.gov\/36936596\/","DOI":"10.1136\/bmjmed-2021-000017"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Kamboj A. K. McGoldrick J. Voth E. Penrice D. Tome J. Gujral A. Miller K. Burke K. E. Pardi D. S. Khalili H. (2022). Clinical characteristics and treatment response in microscopic colitis based on age at diagnosis: A multicenter retrospective study. Digestive Diseases and Sciences 67(7) 3108\u20133114. https:\/\/doi.org\/10.1007\/s10620-021-07162-4","DOI":"10.1007\/s10620-021-07162-4"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Li X. Huang S. Xiao T. Wang X. Kong W. Liu S. Zhang Z. Yang Y. Huang S. Ni X. Lu H. Zhang M. Wen Y. Shang D. (2022). Pharmacokinetics of immediate and sustained-release formulations of paroxetine: Population pharmacokinetic approach to guide paroxetine personalized therapy in Chinese psychotic patients. Frontiers in Pharmacology 13 Article 966622. https:\/\/pubmed.ncbi.nlm.nih.gov\/36172189\/","DOI":"10.3389\/fphar.2022.966622"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Oliva V. Lippi M. Paci R. Del Fabro L. Delvecchio G. Brambilla P. De Ronchi D. Fanelli G. Serretti A. (2021). Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Progress in Neuro-Psychopharmacology & Biological Psychiatry 109 Article 110266. https:\/\/doi.org\/10.1016\/j.pnpbp.2021.110266","DOI":"10.1016\/j.pnpbp.2021.110266"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Salter T. Williams M. D. (2017). Antidepressant-associated microscopic colitis: A case report and literature review. Psychosomatics 58(3) 307\u2013312. https:\/\/doi.org\/10.1016\/j.psym.2017.01.005","DOI":"10.1016\/j.psym.2017.01.005"},{"key":"e_1_3_3_8_1","doi-asserted-by":"crossref","unstructured":"Sikander A. Sinha S. K. Prasad K. K. Rana S. V. (2015). Association of serotonin transporter promoter polymorphism (5-HTTLPR) with microscopic colitis and ulcerative colitis. Digestive Diseases and Sciences 60(4) 887\u2013894. https:\/\/doi.org\/10.1007\/s10620-014-3482-y","DOI":"10.1007\/s10620-014-3482-y"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781108975292"},{"key":"e_1_3_3_10_1","unstructured":"Stoicescu A. Becheanu G. Dumbrava M. Gheorghe C. Diculescu M. (2012). Microscopic colitis\u2013a missed diagnosis in diarrhea-predominant irritable bowel syndrome. Maedica 7(1) 3\u20139. https:\/\/pubmed.ncbi.nlm.nih.gov\/23118812\/"},{"key":"e_1_3_3_11_1","doi-asserted-by":"crossref","unstructured":"Wei L. Singh R. Ghoshal U. C. (2022). Enterochromaffin cells-gut microbiota crosstalk: Underpinning the symptoms pathogenesis and pharmacotherapy in disorders of gut-brain interaction. Journal of Neurogastroenterology and Motility 28(3) 357\u2013375. https:\/\/doi.org\/10.5056\/jnm22008","DOI":"10.5056\/jnm22008"}],"container-title":["Journal of the American Psychiatric Nurses Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10783903261477364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10783903261477364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10783903261477364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:18:41Z","timestamp":1787663921000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10783903261477364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":10,"alternative-id":["10.1177\/10783903261477364"],"URL":"https:\/\/doi.org\/10.1177\/10783903261477364","relation":{},"ISSN":["1078-3903","1532-5725"],"issn-type":[{"value":"1078-3903","type":"print"},{"value":"1532-5725","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"10783903261477364"}}