Severe serotonin syndrome under duloxetine in a patient with coeliac disease — Is there a connection? A case report

Serotonin Syndrome From Duloxetine Monotherapy: A Case Report

“…To date, three serotonin syndrome cases caused by duloxetine monotherapy have been reported. Hansbauer et al reported a 41-year-old white male with coeliac disease who developed serotonin syndrome after administration of duloxetine 60mg [ 8 ]. The authors considered that coeliac disease elevated plasma 5-HT levels and, together with duloxetine, promoted the syndrome's development.…”

“…Gelener et al reported a case of serotonin syndrome in a 29-year-old woman after taking duloxetine 30mg [ 10 ]. The third case was a 24-year-old female who presented with serotonin syndrome after 10 days of continuous administration of duloxetine 30mg [ 8 ]. The syndrome did not resolve completely in this patient until 14 days after discontinuation of duloxetine and the combined usage of cyproheptadine and benzodiazepines.…”

“…Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor, was not included in the list of drugs that may cause serotonin syndrome [ 5 ]. However, three cases of serotonin syndrome have been reported in patients using duloxetine alone at therapeutic doses [ 8 - 10 ]. We report a case of serotonin syndrome caused by duloxetine monotherapy in an elderly Asian woman.…”

“…Many types of drugs and drug interactions are associated with serotonin syndrome, most of which occur in the context of a serotonergic drug overdose and the combined use of monoamine oxidase inhibitors and other related drugs [5]. Cases of serotonin syndrome caused by monotherapy at therapeutic doses are rare but occasionally reported [6][7][8][9]. Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor, was not included in the list of drugs that may cause serotonin syndrome [5].…”