Serotonin syndrome associated with nefazodone and paroxetine.
A 51-year-old woman was brought to the emergency department unresponsive, hyponatremic, and diaphoretic, with muscle rigidity. Her condition improved dramatically after supportive treatment and dantrolene. The patient had received nefazodone for 6 months, but the drug had been discontinued 2 days before admission after a tapering period. One day before admission, paroxetine 20 mg/day was started. A repeat challenge with paroxetine 7 days after discontinuation of nefazodone did not result in recurrence of the patient's symptoms. We believe this to be the first report of serotonin syndrome associated with nefazodone and paroxetine.
John
L
L
Department of Pharmacy, Ottawa General Hospital, Ontario, Canada.
Perreault
M M
MM
Tao
T
T
Blew
P G
PG
D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000378:metabolism; D003128:Coma / Q000139:chemically induced*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced*; D008875:Middle Aged; D017374:Paroxetine / Q000009:adverse effects*; D010879:Piperazines; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D013577:Syndrome; D014230:Triazoles / Q000009:adverse effects* / Q000378:metabolism
D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine; D010879:Piperazines; D017367:Selective Serotonin Reuptake Inhibitors; D014230:Triazoles; C051752:nefazodone