title: Serotonin syndrome in dextromethorphan ingestion responsive to propofol therapy.
abstract: An 18-year-old male developed a severe serotonin syndrome after recreational ingestion of Coricidin HBP (chlorpheniramine 4 mg and dextromethorphan hydrobromide 30 mg). Propofol infusion rapidly normalized his agitation, neuromuscular hyperactivity, and autonomic instability. Confirmatory analysis demonstrated a dextromethorphan serum concentration of 930 ng/mL. Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug.
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA. mganetsky@comcast.net
authors.forename: Michael
authors.initials: M
authors.lastname: Ganetsky
authors.forename: Kavita M
authors.initials: KM
authors.lastname: Babu
authors.forename: Edward W
authors.initials: EW
authors.lastname: Boyer
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects* / Q000097:blood; D000293:Adolescent; D000465:Algorithms; D002744:Chlorpheniramine / Q000009:adverse effects* / Q000097:blood; D003915:Dextromethorphan / Q000009:adverse effects* / Q000097:blood; D004338:Drug Combinations; D062787:Drug Overdose; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D010665:Phenylpropanolamine / Q000009:adverse effects* / Q000097:blood; D015742:Propofol / Q000627:therapeutic use*; D020230:Serotonin Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D004338:Drug Combinations; D006993:Hypnotics and Sedatives; C479098:acetaminophen, chlorpheniramine, dextromethorphan, phenylpropanolamine drug combination; D010665:Phenylpropanolamine; D000082:Acetaminophen; D002744:Chlorpheniramine; D003915:Dextromethorphan; D015742:Propofol