[The serotonin syndrome. Fatal course of intoxication with citalopram and moclobemide].
The serotonin syndrome is caused by a drug-induced increase of the intrasynaptic serotonin concentration. Milder forms of the syndrome may be difficult to diagnose because of the variability of symptoms. Severe forms often rapidly turn into a life-threatening situation, therefore the serotonin syndrome may be a challenge for physicians. We describe the pathophysiology and therapeutic options of the serotonin syndrome and report about a 42-year-old female patient who ingested large amounts of moclobemide, a monoamine oxidase inhibitor, and citalopram, a selective serotonin reuptake inhibitor, for attempted suicide. Within a few hours the patient developed a lethal serotonin syndrome although ICU therapy was initiated immediately.
Cassens
S
S
Zentrum Anästhesie, Rettungs- und Intensivmedizin, Universitätsklinikum, Robert-Koch-Strasse 40, 37075 Göttingen. scassens@zari.de
Nickel
E A
EA
Quintel
M
M
Neumann
P
P
D000328:Adult; D015283:Citalopram / Q000009:adverse effects*; D004562:Electrocardiography; D004632:Emergency Medical Services; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020912:Moclobemide / Q000009:adverse effects*; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects*; D020230:Serotonin Syndrome / Q000503:physiopathology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D013405:Suicide
D015283:Citalopram; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors