J Korean Soc Biol Psychiatry.  2001 Jun;8(1):167-174.

A Case of Severe Serotonin Syndrome Induced by Fluoxetine and Sertraline

• Cheon JS
• Lee SS
• Kim SH
• Cho W

Abstract

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

MeSH Terms

Anxiety
Clonazepam
Cyproheptadine
Emergency Service, Hospital
Epilepsy
Fever
Fluoxetine*
Flushing
Gait Ataxia
Hospitalization
Hospitals, Psychiatric
Humans
Hypotension
Lorazepam
Male
Memory
Middle Aged
Myoclonus
Serotonin Syndrome*
Serotonin Uptake Inhibitors
Serotonin*
Sertraline*
Shivering
Tachycardia
Tremor
Valproic Acid
Clonazepam
Cyproheptadine
Fluoxetine
Lorazepam
Serotonin
Serotonin Uptake Inhibitors
Sertraline
Valproic Acid