A Case Report of Serotonin Syndrome in a Patient on Selective Serotonin Reuptake Inhibitor (SSRI) Monotherapy

Blake, Christie S; Rimola-Dejesus, Yahiada; Nguyen, Thu-Trang; Zaiken, Kathy

doi:10.1177/0897190019841742

Cited by 12 publications

(13 citation statements)

References 21 publications

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“…SSRI monotherapy has been described through case reports but is very rare [6]. This syndrome occurs in 14-16 percent of people who overdose on SSRIs [7]. Serotonin is difficult to diagnose as symptoms are nonspecific and have many mimickers.…”

Section: Discussionmentioning

confidence: 99%

https://promedsci.org/articles/Propofol%20as%20a%20Rare%20Cause%20of%20Serotonin%20Syndrome

Malik¹

2021

Prog Med Sci

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Serotonin is a hormone that has wide-ranging effects on the body including stabilization of mood, feelings of wellbeing, and happiness. Serotonin syndrome was first described in the early 1960s in animals. This syndrome was first fully described in humans by Sternbach in a review of 38 case reports. In this study, it was found that nearly all reported cases were found in patients taking a combination of antidepressants and other agents [1]1 Serotonin syndrome is a disease that is easily missed as there are no defining features in most cases. Symptoms such as confusion and tremors have a gamut of potential causes. Laboratory tests are non-diagnostic with possible changes including an increase in white blood count, creatinine phosphokinase, and decrease in bicarbonate levels. Here we present a case of Serotonin syndrome that was caused by Propofol use in which led to the patient presenting with respiratory arrest. The patient was treated appropriately and was discharged home in good health.

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Section: Discussionmentioning

confidence: 99%

https://promedsci.org/articles/Propofol%20as%20a%20Rare%20Cause%20of%20Serotonin%20Syndrome

Malik¹

2021

Prog Med Sci

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“…One case reported moderate serotonin syndrome involving hyperreflexia and ankle clonus in an adult male on sertraline monotherapy [96]. Most other cases of serotonin syndrome with SSRI monotherapy have involved overdose or switching SSRI therapy without crosstitration [97][98][99]. To prevent serotonin syndrome in patients on SSRIs, providers should exercise caution when combining, switching, or discontinuing these drugs [100].…”

Section: Serotonin Syndromementioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review

Edinoff

Akuly

Hanna

et al. 2021

Neurology International

152

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Depression is the most prevalent psychiatric disorder in the world, affecting 4.4% of the global population. Despite an array of treatment modalities, depressive disorders remain difficult to manage due to many factors. Beginning with the introduction of fluoxetine to the United States in 1988, selective serotonin reuptake inhibitors (SSRIs) quickly became a mainstay of treatment for a variety of psychiatric disorders. The primary mechanism of action of SSRIs is to inhibit presynaptic reuptake of serotonin at the serotonin transporter, subsequently increasing serotonin at the postsynaptic membrane in the serotonergic synapse. The six major SSRIs that are marketed in the USA today, fluoxetine, citalopram, escitalopram, paroxetine, sertraline, and fluvoxamine, are a group of structurally unrelated molecules that share a similar mechanism of action. While their primary mechanism of action is similar, each SSRI has unique pharmacokinetics, pharmacodynamics, and side effect profile. One of the more controversial adverse effects of SSRIs is the black box warning for increased risk of suicidality in children and young adults aged 18–24. There is a lack of understanding of the complexities and interactions between SSRIs in the developing brain of a young person with depression. Adults, who do not have certain risk factors, which could be confounding factors, do not seem to carry this increased risk of suicidality. Ultimately, when prescribing SSRIs to any patient, a risk–benefit analysis must factor in the potential treatment effects, adverse effects, and dangers of the illness to be treated. The aim of this review is to educate clinicians on potential adverse effects of SSRIs.

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“…Selective serotonin reuptake inhibitors (SSRIs) are among the first-line medications used to treat depression, largely due to their efficacy and tolerability 13. The SSRI class includes citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.…”

Section: Serotonergic Agentsmentioning

confidence: 99%

“…1 Of note, in rare cases, serotonin syndrome has been associated with monotherapy of a serotonergic agent. 13 The medications discussed in this article are the most documented contributors to serotonin syndrome. However, this article doesn't contain a comprehensive collection of all known compounds that can cause serotonin syndrome.…”

Section: Serotonergic Agentsmentioning

confidence: 99%

“…Selective serotonin reuptake inhibitors (SSRIs) are among the first-line medications used to treat depression, largely due to their efficacy and tolerability. 13 The SSRI class includes citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. As the name implies, these medications selectively inhibit reuptake of serotonin, which allow for more serotonin in the synaptic gap and enables the post synaptic receptors to become more sensitive to the remaining serotonin.…”

Section: Serotonergic Agentsmentioning

confidence: 99%

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