Possible serotonin syndrome associated with buspirone added to fluoxetine.
OBJECTIVE
To report the development of a possible serotonin syndrome in a patient taking buspirone and fluoxetine.


METHODS
A 37-year-old white man taking fluoxetine 20 mg/d for generalized anxiety disorder developed confusion, diaphoresis, incoordination, diarrhea, and myoclonus after buspirone was added to the drug regimen.


CONCLUSIONS
Serotonin syndrome is a potentially lethal condition of serotonin hyperstimulation, which may develop rapidly or over the course of several weeks. Symptoms of serotonin syndrome typically occur following additions or increases of serotonin-enhancing drugs. Although buspirone has variable effects on post- and presynaptic 5-HT1A receptors that may reduce the risk of serotonin syndrome when administered as a single agent, it may cause an adverse reaction when given with other serotonergic drugs.


CONCLUSIONS
Symptoms consistent with serotonin syndrome may develop with the concurrent administration of buspirone and fluoxetine.
Department of Psychiatry, Naval Medical Center-Portsmouth, VA 23708, USA. ghmanos@iname.com
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Manos
D000328:Adult; D001008:Anxiety Disorders / Q000188:drug therapy; D002065:Buspirone / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005473:Fluoxetine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D012307:Risk Factors; D017366:Serotonin Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D002065:Buspirone; D005473:Fluoxetine; D017366:Serotonin Receptor Agonists; D017367:Selective Serotonin Reuptake Inhibitors