title: Transient serotonin syndrome caused by concurrent use of tramadol and selective serotonin reuptake inhibitor.
abstract: BACKGROUND
  Serotonin syndrome is a potentially life-threatening adverse drug reaction that most commonly results from adverse interactions between drugs. Because serotonin syndrome can be fatal and is often difficult to diagnose, it is vital for health professionals to know about this reaction. We report a typical case of transient serotonin syndrome secondary to tramadol-Citalopram combination. This case report highlights the value of awareness of the early and subtle signs of serotonin syndrome.
  
  
  METHODS
  A 44-year-old female with past medical history of chronic pancreatitis, back pain, and major depression was brought to the emergency room (ER) with altered mental status, jerky movements in extremities, generalized weakness, and vomiting.
  
  
  CONCLUSIONS
  Most physicians are aware of serotonin syndrome secondary to antidepressants but do not think about other classes of medications such as analgesics. Clinicians should also be aware of the possibility of serotonin syndrome when encountering a patient taking serotonergic drugs who presents with characteristic symptoms of serotonin syndrome.
authors.affiliation: Department of Internal Medicine, Baystate Medical Center, Springfield, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shakoor
authors.affiliation: Department of Pulmonary and Critical Care, University of Arkansas for Medical Sciences, Little Rock, USA.
authors.forename: Samia
authors.initials: S
authors.lastname: Ayub
authors.affiliation: Department of Internal Medicine, Nishter Medical College, Multan, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Ahad
authors.affiliation: Department of Internal Medicine, Fatima Jinnah Medical College, Lahore, Pakistan.
authors.forename: Zunaira
authors.initials: Z
authors.lastname: Ayub
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D059350:Chronic Pain / Q000150:complications / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D020230:Serotonin Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D014147:Tramadol / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D017367:Selective Serotonin Reuptake Inhibitors; D014147:Tramadol