There are several case reports and case series that have examined the acute effects of selective serotonin reuptake inhibitors (SSRIs) on the newborn. There is considerable controversy whether the reported symptoms represent withdrawal from the SSRI or toxicity caused by the SSRI. A case of an infant who was exposed to paroxetine during pregnancy is presented. This case supports the notion of serotonin toxicity and is believed to be the first report that substantiates clinical symptoms with serum levels of the offending SSRI.