Two Cases of Serotonin Syndrome

J Korean Neurol Assoc > Volume 17(4); 1999 > Article

Journal of the Korean Neurological Association 1999;17(4): 591-596.

세로토닌 증후군 2예

곽용태, 한일우 강성숙*구민성**김옥준***

용인효자병원 신경과,용인정신병원 정신과*,신촌세브란스병원 정신과**·신경과***

Two Cases of Serotonin Syndrome

Yong-Tae Kwak, M.D., Il-Woo Han, Seong-Suk Kang*, M.D., Min-Seong Koo**, M.D, Ok-Joon Kim***, M.D.

Department of Neurology, Yong-in Hyoja Geriatric Hospital Department of Psychiatry, Yong-in Mental Hospiatl* Department of Psychiatry**, Department of Neurology***, Yonsei University College of Medicine

Abstract

We report 2 cases of serotonin syndrome with variable symptoms after being treated with antidepressants. A 57-year-old woman developed agitation, diaphoresis, and tremor after combination therapy with fluoxetine and trazodone. The second patient, a 76-year-old female woman, became partially disoriented and developed brief, jerky myoclonus of all extremities after discontinuation of sertraline and consecutive imipramine treatment. These two patients rapidly improved with supportive care. The serotonin syndrome is not always easy to diagnose and sometimes causes a serious and fatal event. For this reason, if possible, the practice of multiple serotonergic drugs should be avoided because of the risk for potential serious pharmacodynamic drug interactions. Clinicians should not view the serotonin syndrome as an idiosyncratic reaction, but rather, as a predictable one with a variability in occurrence and severity among patients. Heightened awareness by clinicians will help to minimize pharmacodynamically mediated interactions that may occur between prescribed drugs and, ideally avoid this syndrome. J Kor Neurol Ass 17(4):591~595, 1999 Key Words : Serotonin Syndrome, Antidepressants