Serotonin Syndrome after Initiation of Pregabalin on a Stable Regimen of Antidepressant Medication

Abstract

Aims: Serotonin syndrome is a potentially life-threatening drug interaction caused by excess serotonin concentration in the central nervous system and/or peripheral nervous system leading to cognitive, autonomic and somatic effects ranging from barely perceptible to fatal. A number of drugs and drug interactions cause serotonin syndrome, however, the exact mechanisms often remain elusive. Presentation of Case: In the following case, serotonin syndrome was caused by the addition of pregabalin in a patient with recurrent major depressive disorder and concurrent medication with paroxetine and trazodone. Discussion: This case illustrates the risk of polypsychopharmacology leading to an increased vulnerability towards serotonin syndrome. Conclusion: Pregabalin with its serotonergic action has a liability to cause serotonin syndrome. This should be especially kept in mind in patients with polypsychopharmacology. ABSTRACTAims: Serotonin syndrome is a potentially life-threatening drug interaction caused by excess serotonin concentration in the central nervous system and/or peripheral nervous system leading to cognitive, autonomic and somatic effects ranging from barely perceptible to fatal. A number of drugs and drug interactions cause serotonin syndrome, however, the exact mechanisms often remain elusive. Presentation of Case: In the following case, serotonin syndrome was caused by the addition of pregabalin in a patient with recurrent major depressive disorder and concurrent medication with paroxetine and trazodone. Discussion: This case illustrates the risk of polypsychopharmacology leading to an increased vulnerability towards serotonin syndrome. Conclusion: Pregabalin with its serotonergic action has a liability to cause serotonin syndrome. This should be especially kept in mind in patients with polypsychopharmacology. Jellestad et al.; IJMPCR, 7(5): 1-4, 2016; Article no.IJMPCR.28356 2 Case Study

Neurotoxic Assessment of Chronic Abuse of Pregabalin in Wistar Rats

“…On the other hand, our data demonstrated a significant elevation in brain serotonin level after prolonged administration of pregabalin in high doses. Jellestad et al [27] reported that Pregabalin with its serotonergic action has a liability to cause serotonin syndrome which is caused due to excess serotonin concentration in the central nervous system and/or peripheral nervous system leading to cognitive, autonomic, and somatic effects. Gabapentin, an analog of pregabalin, has been shown to increase serotonin levels in the CNS [28] via inducing alterations in central serotonin metabolism [29].…”