[Serotonin syndrome: report of a fatal case and review of the literature].
We report here the case of a patient with fluoxetine and selegiline induced serotonin syndrome, which presented as encephalopathy, generalized myoclonias, fever, stiffness and sweating, complicated with acute renal failure, rhabdomyolysis and disseminated intravascular coagulation findings. The patient died 6 days after admission. This syndrome is discussed, with an analysis of its causes, pathophysiology and therapy. A special emphasis is placed on the clinical issues and differential diagnosis with the malignant neuroleptic syndrome and other clinical entities with which it could be mistaken. General recommendations are provided to avoid this poorly characterized syndrome that, as in our patient, may have a fatal outcome.
Bilbao Garay
J
J
Servicio de Medicina Interna, Fundación Hospital Alcorcón, Madrid, Spain. jbilbao@fhalcorcon.es
Mesa Plaza
N
N
Castilla Castellano
V
V
Dhimes Tejada
P
P
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D002230:Carbidopa / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000209:etiology; D004338:Drug Combinations; D004357:Drug Synergism; D017809:Fatal Outcome; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology; D012642:Selegiline / Q000009:adverse effects; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects
D000978:Antiparkinson Agents; D002230:Carbidopa; D004338:Drug Combinations; D005473:Fluoxetine; D007980:Levodopa; D012642:Selegiline; D017367:Selective Serotonin Reuptake Inhibitors; C009265:carbidopa, levodopa drug combination