title: Suspected serotonin syndrome in a patient being treated with methylene blue for ifosfamide encephalopathy.
abstract: Methylene blue has been used not only as a diagnostic agent, but also as an agent in the treatment of ifosfamide-induced encephalopathy (IIE) for several years. Recently, several cases of suspected serotonin syndrome have been reported in patients who received methylene blue in combination with serotonin active agents. Rodent models have revealed that methylene blue is a potent, reversible inhibitor of monoamine oxidase A. It is well known that serotonin active drugs, in combination with monoamine oxidase inhibitors can produce profound serotonin syndrome. To date, cases of serotonin syndrome, which resulted from concurrent methylene blue and serotonin active agents, have been published in the anesthesia literature. We report the first known case of serotonin syndrome in a patient receiving methylene blue for IIE.
authors.affiliation: Department of Pharmacy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. amcdonnell@partners.org
authors.forename: A M
authors.initials: AM
authors.lastname: McDonnell
authors.forename: I
authors.initials: I
authors.lastname: Rybak
authors.forename: M
authors.initials: M
authors.lastname: Wadleigh
authors.forename: D C
authors.initials: DC
authors.lastname: Fisher
mesh_terms: D001927:Brain Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects* / Q000627:therapeutic use; D008751:Methylene Blue / Q000009:adverse effects* / Q000627:therapeutic use; D020230:Serotonin Syndrome / Q000139:chemically induced* / Q000209:etiology*
chemical_list: D008751:Methylene Blue; D007069:Ifosfamide