The serotonin syndrome and psychosis-like side-effects of fluvoxamine clinical use--an estimation of incidence.
OBJECTIVE
The incidence of the serotonin syndrome or serotonin-syndrome-like side effects during treatment with the selective serotonin reuptake inhibitor (SSRI) fluvoxamine should be evaluated.


METHODS
200 inpatients treated for the first time with fluvoxamine were prospectively evaluated for the occurrence of a serotonin syndrome over a period of 8200 treatment days. Retrospective follow-up data of outpatient treatment covered 8891 days.


RESULTS
No full-blown serotonin syndrome occurred, but 3 patients developed a reversible change of mental status with insomnia, agitation, confusion and incoherent thoughts without other symptoms of the serotonin syndrome.


CONCLUSIONS
It is concluded that the occurrence of a potentially lethal serotonin syndrome is rare in fluvoxamine treatment psychosis-like syndromes as a side effect of serotonergic stimulation might occur. In the investigated sample the rate was 0.006-0.04 per 100 treatment days.
Ebert
D
D
Department of Psychiatry, University of Freiburg, Germany.
Albert
R
R
May
A
A
Merz
A
A
Murata
H
H
Stosiek
I
I
Zahner
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D005260:Female; D016666:Fluvoxamine / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011605:Psychoses, Substance-Induced / Q000453:epidemiology*; D012189:Retrospective Studies; D018490:Serotonin Agents / Q000009:adverse effects*
D018687:Antidepressive Agents, Second-Generation; D018490:Serotonin Agents; D016666:Fluvoxamine