Recognition and mangement of serotonin syndrome

Kenicer, David; Krishnadas, Rajeev

doi:10.1002/psb.1388

Cited by 3 publications

(1 citation statement)

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“…These symptoms are consistent with mild serotonin syndrome and may have been overlooked, given the similarity of symptoms observed in comorbid conditions. 19 Upon further evaluation and completion of laboratory assessment, it was determined that the patient's symptoms were not due to the use of an opioid or dopamine antagonist and were not associated with any other pharmacologic, therapeutic, or herbal agent. The findings from multiple laboratory tests also ruled out other medical conditions as the cause of the patient's symptoms.…”

Section: Discussionmentioning

confidence: 99%

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

Blake

Rimola-Dejesus

Nguyen

et al. 2019

Journal of Pharmacy Practice

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Introduction: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with several indications, one of which is for depression. We present a case of probable paroxetine-induced serotonin syndrome. Case Summary: A 21-year-old female with a history of generalized anxiety disorder and major depression presented with increased depressive symptoms over several months while taking fluoxetine 20 mg daily. Fluoxetine was discontinued without taper and replaced with paroxetine 10 mg daily, along with hydroxyzine 50 mg twice daily as needed for anxiety. Within a week of starting the paroxetine, the patient reported increased anxiety, insomnia, and constant shaking. The paroxetine continued to be uptitrated over a 3-week period to a dose 30 mg due to unremitting depressive symptoms. One month later, the patient presented with tachycardia, generalized body aches, extreme fatigue, weakness, uncontrollable twitching, tremor, and hyperreflexia. A widespread burning sensation accompanied by random hot flashes without diaphoresis was also noted. Serotonin syndrome was diagnosed using the Hunters criteria. Paroxetine was discontinued, and the patient’s physical symptoms resolved within a week. Discussion: To date, only 5 cases of serotonin syndrome have been reported in patients receiving SSRI monotherapy at recommended therapeutic doses.

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Section: Discussionmentioning

confidence: 99%