Review Article of International Journal of Hospital Pharmacy
Selective Serotonin Reuptake Inhibitors Induced Serotonin Syndrome –A Case Report
Ananth kashyap*, Rashmi N G, Rakshith U R, Hanumanthachar Joshi
Smriti College of Pharmaceutical Education, Indore
Serotonin syndrome also known as serotonin toxicity is a potentially life threatening syndrome that is precipitated due to excess serotonin within CNS. It results in variety of mental, autonomic and neuromuscular changes which ranges in severity from mild to fatal. It is nearly always caused by drug interaction involving two or more serotonergic drugs atleast one which is SSRIs. This is a case of 35- year- old female patient, admitted to hospital with 2 episodes of seizures, fever, headache, depression and was put on sodium valproate, clonazepam+escitalopram, paracetamol, sertraline. The patient medical history reveals that she is a known case of major depression and syncopal attack and was on escitalopram oxolate from 1 year. After two days of therapy patient developed tremors, restlessness, muscle rigidity, shivering and was clonus. On examination, variation in vitals was noticed and diagnosed as serotonin syndrome by review of medication chart sertraline was stopped and lorazepam was administered and patient showed good response and felt better. Proper education and awarness about drugs, drug-drug interaction causing SS its accuracy of diagnosis that prevents morbitiy and mortality in patients prescribed with SSRIs is of utmost importance.
Keywords: Serotonin syndrome, Selective serotonin reuptake inhibitors, Drug-drug interaction.
How to cite this article:
Ananth kashyap*, Rashmi N G, Rakshith U R, Hanumanthachar Joshi.Selective Serotonin Reuptake Inhibitors Induced Serotonin Syndrome –A Case Report. International Journal of Hospital Pharmacy, 2017,2:7. DOI:10.28933/ijhp-2017-10-1101
1 Michael Hall, Nick Buckley. Serotonin Syndrome. Australian prescriber. 2003;26(3):19.
2 Selective Serotonin Reuptake Inhibitor Toxicity. Medscape.http://emedicine.medscape.com/article/821737-overview(Accessed on 3 July 2017).
3 Jacqueline Volpi-Abadie, Adam M.Kaye, Alan David Kaye. Serotonin Syndrome. The Ochsner Journal. 2013;13(4):533-540.
4 Ursula Werneke, Fariba Jamshidi, David M.Taylor, Michael Ott. Conundrums in neurology: diagnosing serotonin syndrome-a meta-analysis of cases. BMC Neurology. 2016;16:97.
5 Edward W.Boyer, Michael Shannon. The Serotonin Syndrome. The New England Journal of Medicine. 2005;352:1112-20.
6 Charles H.Brown. Drug-Induced Serotonin Syndrome. U.S.Pharmacist. 2010;35(11):16-21.
7 Perry PJ, Wilborn CA. Serotonin syndrome vs neuroleptic malignant syndrome: a contrast of causes, diagnoses and management. Annals of Clinical Psychiatry. 2012;24(2):155-62.
8 Bettina C.Prator. Serotonin Syndrome. The Journal of Neuroscience Nursing. 2006;38(2):102-105.
9 Philippe Birmes, Dominique Coppin, Laurent Schmitt, Dominique Lauque. Serotonin syndrome:a brief review. Canadian Medical Association Journal. 2003;168:11.
10 Christopher Frank. Recognition and treatment of serotonin syndrome. Canadian Family Physician. 2008;54(7):988-992.