title: Serotonin syndrome caused by minimum doses of SSRIS in a patient with spinal cord injury.
abstract: There have been only a few reports of serotonin syndrome developing after mono-therapy with a selective serotonin reuptake inhibitor (SSRI). We report a case of serotonin syndrome caused by long-term therapy with fluvoxamine prior to treatment with paroxetine. An 18-year-old man with spinal cord injury (SCI) at thoracic level 2-3 presented with onset of serotonin syndrome after taking fluvoxamine (50 mg per day) for 8 weeks prior to treatment with paroxetine (10 mg per day) for 6 days. He had confusion, agitation, severe headache, tachycardia (124 beats/minute), hypertension (165/118 mmHg), high fever (39.1 degrees C), and myoclonus. All of the symptoms disappeared within 24 hours after discontinuation of administration of paroxetine. This is an interesting case of serotonin syndrome that developed after minimum doses of single therapy with an SSRI in a patient with SCI.
authors.affiliation: Institute of Physical Medicine and Rehabilitation, Fukushima Medical University School of Medicine, Japan. kouichi@fmu.ac.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Satoh
authors.forename: Shizuko
authors.initials: S
authors.lastname: Takano
authors.forename: Takashi
authors.initials: T
authors.lastname: Onogi
authors.forename: Koji
authors.initials: K
authors.lastname: Ohtsuki
authors.forename: Toshio
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016666:Fluvoxamine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000188:drug therapy*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016666:Fluvoxamine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors