Encephalophaty associated with rasagiline and sertraline in Parkinson's disease: Possible serotonin syndrome

Duval, Fanny; Flabeau, Olivier; Razafimahefa, Julien; Spampinato, Umberto; Tison, François

doi:10.1002/mds.25416

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…A case of probable 5-HT syndrome was reported in a 75-year-old woman taking L-DOPA/carbidopa/entacapone, amantadine and rasagiline 1 mg id, one week after sertraline was increased to 100 mg id [311]. …”

Section: Sert Inhibitorsmentioning

confidence: 99%

Monoamine Reuptake Inhibitors in Parkinson’s Disease

Huot

Fox

Brotchie

2015

Parkinson's Disease

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The motor manifestations of Parkinson's disease (PD) are secondary to a dopamine deficiency in the striatum. However, the degenerative process in PD is not limited to the dopaminergic system and also affects serotonergic and noradrenergic neurons. Because they can increase monoamine levels throughout the brain, monoamine reuptake inhibitors (MAUIs) represent potential therapeutic agents in PD. However, they are seldom used in clinical practice other than as antidepressants and wake-promoting agents. This review article summarises all of the available literature on use of 50 MAUIs in PD. The compounds are divided according to their relative potency for each of the monoamine transporters. Despite wide discrepancy in the methodology of the studies reviewed, the following conclusions can be drawn: (1) selective serotonin transporter (SERT), selective noradrenaline transporter (NET), and dual SERT/NET inhibitors are effective against PD depression; (2) selective dopamine transporter (DAT) and dual DAT/NET inhibitors exert an anti-Parkinsonian effect when administered as monotherapy but do not enhance the anti-Parkinsonian actions of L-3,4-dihydroxyphenylalanine (L-DOPA); (3) dual DAT/SERT inhibitors might enhance the anti-Parkinsonian actions of L-DOPA without worsening dyskinesia; (4) triple DAT/NET/SERT inhibitors might exert an anti-Parkinsonian action as monotherapy and might enhance the anti-Parkinsonian effects of L-DOPA, though at the expense of worsening dyskinesia.

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Section: Sert Inhibitorsmentioning

confidence: 99%

Monoamine Reuptake Inhibitors in Parkinson’s Disease

Huot

Fox

Brotchie

2015

Parkinson's Disease

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“…61 In SS, an initial dose of 12 mg is recommended, followed by 2 mg every 2 h to a maximum of 32 mg in 24 h until symptoms settle. 62 This dose was insufficient in our case. Our patient showed a good initial response but relapsed after 8-11 h under maintenance with 2 mg every 2 h. While the effect faded, we were able to control the BP with CCB and beta blocker.…”

Section: Understanding Hypertension In the Context Of Serotonin Toxicitymentioning

confidence: 64%

Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques

Ott

Mannchen

Jamshidi

et al. 2019

Therapeutic Advances in Psychopharmacology

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Serotonin syndrome is thought to arise from serotonin excess. In many cases, symptoms are mild and self-limiting. But serotonin syndrome can become life threatening, when neuromuscular hyperexcitability spins out of control. Uncontainable neuromuscular hyperexcitability may lead to cardiovascular complications, linked to extreme changes in blood pressure. Currently, there is little guidance on how to control blood pressure in hyperserotonergic states. We report a case with treatment-resistant arterial hypertension, followed by a clinical review (using systematic review principles and techniques) of the available evidence from case reports published between 2004 and 2016 to identify measures to control arterial hypertension associated with serotonin syndrome. We conclude that classic antihypertensives may not be effective for the treatment of severe hypertension associated with serotonin syndrome. Benzodiazepines may lower blood pressure. Patients with severe hypertension not responding to benzodiazepines may benefit from cyproheptadine, propofol or both. In severe cases, higher cyproheptadine doses than currently recommended may be necessary.

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“…It remains unclear whether this was secondary to serotonin toxicity, Parkinson's disease, or a combination of the two. While further workup is warranted to definitively exclude Parkinson's disease, there have been reported clinical cases with serotonin syndrome in the setting of Parkinson's disease [6,7]. This patient's presentation satisfied both sets of Sternbach's and Hunter's serotonin toxicity criteria via the clinical manifestation of anxiety, agitation, hypertonicity, rigidity, and tremors [4].…”

Section: Discussionmentioning

confidence: 77%

Serotonergic Medication Error: A Case Report of Serotonin Syndrome

Nguyen,

Fisher,

Valentine

et al. 2023

Cureus

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Serotonin syndrome (SS) describes a life-threatening clinical condition that can develop within hours or days after taking serotonergic medication(s). Medication adverse reactions, overdose, or drug interactions can cause this syndrome. Patients often present with symptoms of hyperthermia, muscle rigidity, hyperreflexia, and clonus. Symptoms range broadly in severity, often influenced by polypharmacy and age. In this report, SS was diagnosed in an elderly patient who presented with diffuse urticaria and exacerbated tremor. These complaints were thought to be associated with Parkinson's disease due to a strong family history. Clinicians are encouraged to consider SS in their differential diagnosis when dealing with elderly patients with multiple medications, psychiatric diagnoses, conditions managed by other providers, and/or a strong family history of neurodegenerative diseases.

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Encephalophaty associated with rasagiline and sertraline in Parkinson's disease: Possible serotonin syndrome

Cited by 10 publications

References 7 publications

Monoamine Reuptake Inhibitors in Parkinson’s Disease

Monoamine Reuptake Inhibitors in Parkinson’s Disease

Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques

Serotonergic Medication Error: A Case Report of Serotonin Syndrome

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