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Comment in:
Serotonin syndrome
induced by fluvoxamine and mirtazapine.
Demers JC,
Malone M.
Albany College of Pharmacy, NY,
USA.
OBJECTIVE: To document a case of serotonin syndrome
associated with the combined use of fluvoxamine and mirtazapine, and to
discuss the pharmacodynamic and pharmacokinetic interactions that were
the likely causes of this potentially serious adverse drug reaction
(ADR). CASE SUMMARY: A 26-year-old white woman with a 12-year history of
anorexia nervosa was being treated with fluvoxamine. After mirtazapine
was added to her therapy, she developed tremors,restlessness, twitching,
flushing, diaphoresis, and nausea,symptoms that are consistent with
serotonin syndrome. DISCUSSION: The possible causes of this ADR are
discussed, including the effects of fluvoxamine and mirtazapine alone,
the possible pharmacodynamic and pharmacokinetic interactions of these
two drugs, and the patients underlying anorexia nervosa. CONCLUSIONS: An
increasing number of drugs that affect serotonin are available and are
indicated for various disorders. Since there is a significant likelihood
of these agents being prescribed concomitantly, clinicians must be aware
of possible interactions that could lead to serotonin
syndrome.
Publication Types:
PMID: 11675850 [PubMed - indexed for
MEDLINE]
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