Serotonin syndrome in a child associated with erythromycin and sertraline.
Serotonin syndrome is an uncommon, serious adverse reaction that is usually associated with the interaction of two or more serotonergic agents. A 12-year-old boy receiving sertraline developed the syndrome after erythromycin was added to his regimen. The proposed mechanism involves erythromycin inactivation of cytochrome P450 3A4 inhibition of sertraline metabolism, accumulation of the drug, and precipitation of the syndrome. It is important for clinicians to consider both pharmacokinetic and pharmacodynamic interactions to minimize the risk of the reaction.
Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA.
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D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004917:Erythromycin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D020280:Sertraline / Q000009:adverse effects* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline