Fatal serotonin syndrome precipitated by oxcarbazepine in a patient using an selective serotonin reuptake inhibitor.
Oxcarbazepine, a metabolite of carbamazepine, is used as an antiepileptic, analgesic for neuropathic pain and in the treatment of affective disorders. It has been approved by the Food and Drug Administration for partial seizures in adults as both adjunctive and monotherapy, and as adjunctive therapy in children aged from 2 to 16 years (http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4254b_07_05_KP%20OxcarbazepineFDAlabel102005.pdf). We present a case of serotonin syndrome, which was precipitated by this medicine in a patient who had been predisposed by long-term treatment with sertraline, a selective serotonin reuptake inhibitor. This is the first reported fatality due to this drug interaction and only the second case of serotonin syndrome reported with oxcarbazepine. Physicians should consider this risk when prescribing the above combination.
Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA. christopherdardis@gmail.com
Christopher
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Dardis
Eghosa
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Omoregie
Vanthanh
V
Ly
D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000150:complications; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D003324:Coronary Artery Disease / Q000150:complications; D003863:Depression / Q000150:complications / Q000188:drug therapy; D003920:Diabetes Mellitus; D003929:Diabetic Neuropathies / Q000150:complications; D004347:Drug Interactions; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000150:complications; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D009437:Neuralgia / Q000188:drug therapy; D000078330:Oxcarbazepine; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D020230:Serotonin Syndrome / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D020280:Sertraline / Q000008:administration & dosage*
D000700:Analgesics; D000959:Antihypertensive Agents; D001993:Bronchodilator Agents; D002220:Carbamazepine; D007004:Hypoglycemic Agents; D000078330:Oxcarbazepine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline