Serotonin syndrome during treatment with low dose of escitalopram associated with miconazole mucoadhesive tablet: a suspected drug interaction

Abstract

Antidepressant treatments, including selective serotonin reuptake inhibitors, are associated in older adults with an increased risk of adverse effects compared to younger adults. This is partly explained by multiple drug use causing drug-drug interactions. In the present report, we describe a case of serotonin syndrome in an 88-year-old woman receiving a low dose of escitalopram. The onset of this episode could have been induced by a drug-drug interaction with an acute treatment by miconazole gingival adhesive tablets. The lack of pharmacokinetic data in the elderly population should prompt us to be especially cautious about prescription of this new formulation of miconazole in association with drugs metabolized by cytochromes P450 isoenzymes.

Serotonin syndrome induced by the readministration of escitalopram after a short-term interruption in an elderly woman with depression: a case report

“…One such case involved an 88-year-old female who experienced an interaction between 5 mg of escitalopram and 50 mg of miconazole. 7 A second case involved a 27-year-old female who experienced an interaction between 10 mg of escitalopram and 50–60 mg of cyclobenzaprine. 8 Finally, a third case involved a 65-year-old female who experienced an interaction between 10 mg of escitalopram and 600 mg of the antibiotic linezolid.…”

Serotonin Syndrome with Escitolapram and Concomitant Use of Cocaine: A Case Report

“…1 No single receptor appears to be responsible for the development of the Serotonin syndrome, although several studies suggest that agonism of serotonin-1A (5-HT1A) and serotonin-5A (5-HT2A) receptors contribute substantially to the condition. 2 Cocaine prevents serotonin uptake and its combination with esciolapram may lead to serotonin syndrome. 9 The diagnosis of Serotonin syndrome is made clinically.…”