[Serotonin syndrome as a result of concomitant use of paroxetine and sumatriptan].
A 65-year-old woman was referred with confusion, strange behaviour, sinus tachycardia, hypertension and hyperthermia. She had been taking sumatriptan and paroxetine and recovered completely after discontinuation of these agents. The diagnosis was 'serotonin syndrome', a result of overstimulation of 5-HT(1A) receptors in the raphe nuclei of the brainstem. It is a complication of the use of serotonergic agents and is associated with the rapid onset of mental, autonomic and neurological symptoms. Treatment consists of discontinuation of the suspected medication and, in severe cases, providing symptomatic relief. Given the frequent prescription of (combinations of) serotonergic agents, one should be aware of this complication.
Hendrix
Y
Y
Jeroen Bosch Ziekenhuis, locatie GZG, afd. Neurologie, 's-Hertogenbosch. yhhendrix@hotmail.com
van Zagten
M S G
MS
D000368:Aged; D001933:Brain Stem / Q000187:drug effects / Q000378:metabolism; D004357:Drug Synergism; D005260:Female; D006801:Humans; D017374:Paroxetine / Q000009:adverse effects* / Q000627:therapeutic use; D011985:Receptors, Serotonin / Q000187:drug effects / Q000378:metabolism*; D012701:Serotonin / Q000378:metabolism*; D017366:Serotonin Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D018170:Sumatriptan / Q000009:adverse effects* / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome
D017374:Paroxetine; D011985:Receptors, Serotonin; D012701:Serotonin; D017366:Serotonin Receptor Agonists; D017367:Selective Serotonin Reuptake Inhibitors; D018170:Sumatriptan