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[Case of prolonged recovery from
serotonin syndrome caused by paroxetine]
[Article in
Japanese]
Ochiai Y, Katsu H, Okino S, Wakutsu N, Nakayama
K.
Department of Psychiatry, Jikei University School of
Medicine.
We report a case of serotonin syndrome in a patient
being treated with paroxetine for depression. Despite prompt
discontinuation of medication, his serotonin syndrome continued for 10
days before full consciousness was restored. The patient was a
48-year-old male with chief complaints of hypobulia and suicidal
thoughts. He consulted as a psychiatric outpatient, and oral paroxetine
20 mg/day, etizolam 1.0 mg/day, and brotizolam 0.25 mg/day were
immediately started. Upsurge of feeling and disinhibition state were
noted the following day, then on treatment day 6 his condition
deteriorated to substupor state and he was admitted for further
treatment. On admission, change of mental condition (consciousness
disturbance), perspiration, hyperreflexia, myoclonus and tremor were
seen, and serotonin syndrome caused by paroxetine was suspected.
Paroxetine was thus discontinued, and under intravenous drip his
condition gradually improved. However, it was not until the 10th
hospital day that he became fully alert. In examinations, no infectious,
metabolic or organic diseases were detected. The patient's condition
often improves with in 24 hours of discontinuation of the causative
medication in serotonin syndrome. Symptoms continued for 10 days in this
patient, however, perhaps because paroxetine was administered for 6 days
before discontinuation. In addition, interaction with other medications
may have occurred. Therefore, when serotonin syndrome is suspected,
prompt discontinuation of the suspected causative medication, followed
by close monitoring of the pharmacokinetics is
warranted.
Publication Types:
PMID: 15027311 [PubMed - indexed for
MEDLINE]
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