Case Report
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FLUOKSETİN VE DÜŞÜK DOZ TRAZODONUN BİRLİKTE KULLANIMIYLA OLASI SEROTONİN SENDROMU DÜŞÜNDÜREN VE NARANJO İLAÇ YAN ETKİSİ OLASILIĞI ÖLÇEĞİ İLE DEĞERLENDİRİLEN BİR OLGU

Year 2023, Volume: 30 Issue: 3, 572 - 577, 23.09.2023
https://doi.org/10.17343/sdutfd.1210458

Abstract

Serotonin sendromu serotonerjik ajan kullanımı sonrasında
oluşan serotonin reseptörlerinin aşırı uyarılması
sonucu gelişen nadir görülen fakat mortal seyredebilen
sendromdur. Klinik belirti ve bulgular kognitif,
nöromüsküler ve otonomik alanda görülmektedir. Serotonerjik
etkili bir veya daha fazla ajanın birlikte kullanılması
bu sendroma neden olur. Klinik görünümü hafif
şiddette olup gözden kaçabilen olgular olduğu gibi
hayatı tehdit eden, yoğun bakım ve mekanik ventilasyon
gerektiren şiddette de olabilmektedir. Bu yazıda
fluoksetin tedavisine trazodon eklenmesi ve doz artırılması
sonrasında 24 saat içerisinde gelişen serotonin
sendromu düşündüren bir vaka sunulmuştur.

References

  • 1. Scotton WJ, Hill LJ, Williams AC, Barnes NM. Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions. International Journal of Tryptophan Research. 2019;12:1178646919873925.
  • 2. Özdemir S, Kocabaşoǧlu N. Serotonin Sendromuna Güncel Bir Yaklaşım. Klinik Psikofarmakoloji Bulteni. 2007;17(4).
  • 3. Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991;148(6):705-13.
  • 4. Dunkley E, Isbister G, Sibbritt D, Dawson A, Whyte I. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Qjm. 2003;96(9):635-42.
  • 5. Radomski J, Dursun S, Reveley M, Kutcher S. An exploratory approach to the serotonin syndrome: an update of clinical phenomenology and revised diagnostic criteria. Medical hypotheses. 2000;55(3):218-24.
  • 6. Coleman JJ, Pontefract SK. Adverse drug reactions. Clinical Medicine. 2016;16(5):481.
  • 7. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts E, et al. A method for estimating the probability of adverse drug reactions. Clinical Pharmacology & Therapeutics. 1981;30(2):239-45.
  • 8. Karunatilake H, Buckley NA. Serotonin syndrome induced by fluvoxamine and oxycodone. Annals of Pharmacotherapy. 2006;40(1):155-7.
  • 9. Ailawadhi S, Sung KW, Carlson L, Baer M. Serotonin syndrome caused by interaction between citalopram and fentanyl. Journal of clinical pharmacy and therapeutics. 2007;32(2):199- 202.
  • 10. Pan J-J, Shen WW. Serotonin syndrome induced by low-dose venlafaxine. Annals of Pharmacotherapy. 2003;37(2):209-11.
  • 11. Inaguma D, Kitagawa W, Hayashi H, Kanoh T, Kurata K, Kumon S. Three cases of severe hyponatremia under taking selective serotonin reuptake inhibitor (SSRI). Nihon Jinzo Gakkai Shi. 2000;42(8):644-8.
  • 12. Kirby D, Harrigan S, Ames D. Hyponatraemia in elderly psychiatric patients treated with selective serotonin reuptake inhibitors and venlafaxine: a retrospective controlled study in an inpatient unit. International journal of geriatric psychiatry. 2002;17(3):231-7.
  • 13. Oruch R, Pryme IF, Engelsen BA, Lund A. Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatric disease and treatment. 2017:161-75.
  • 14. Bartlett D. Drug-induced serotonin syndrome. Critical care nurse. 2017;37(1):49-54.
  • 15. Kan R, Endou M, Unno Y. A case of serotonin syndrome following minimum doses of sertraline. Seishin Shinkeigaku Zasshi=Psychiatria et Neurologia Japonica. 2009;111(9):1041-6.
  • 16. Gelener P, Gorgulu U, Kutlu G, Ucler S, Inan LE. Serotonin syndrome due to duloxetine. Clinical Neuropharmacology. 2011;34(3):127-8.
  • 17. Öztürk N, Ezgi K, Sözeri-Varma G, Değirmenci E. Düşük doz essitalopram ile serotonin sendromu. Journal of Mood Disorders. 2013;3(1):37-40.
  • 18. Stahl SM. Prescriber's guide: Antidepressants: Stahl's essential psychopharmacology: Cambridge University Press; 2017.
  • 19. George TP, Godleski LS. Possible serotonin syndrome with trazodone addition to fluoxetine. Biological psychiatry. 1996;39(5):384-5.
  • 20. Rao R. Serotonin syndrome associated with trazodone. International journal of geriatric psychiatry. 1997;12(1):129-30.
  • 21. Reeves RR, Bullen JA. Serotonin syndrome produced by paroxetine and low-dose trazodone. Psychosomatics: Journal of Consultation and Liaison Psychiatry. 1995.

A CASE POSSIBLE SEROTONIN SYNDROME CASE CAUSED BY COMBINED USE OF FLUOXETINE AND LOW DOSE TRAZODONE AND ASSESSED BY THE NARANJO ADVERSE DRUG REACTION PROBABILITY SCALE

Year 2023, Volume: 30 Issue: 3, 572 - 577, 23.09.2023
https://doi.org/10.17343/sdutfd.1210458

Abstract

Serotonin syndrome is a rare but life-threatening
syndrome that develops as a result of excessive
stimulation of serotonin receptors after the use of
serotonergic agents. Clinical signs and symptoms
are seen in the cognitive, neuromuscular and
autonomic areas. Combination of one or more drugs
with serotonergic effect causes this syndrome. While
there are cases with a mild clinical appearance that
can be overlooked, they can also be life-threatening
and require intensive care and mechanical ventilation.
In this article, a case of serotonin syndrome, which
developed within 24 hours after adding trazodone to
fluoxetine treatment and increasing the dose, was
presented.

References

  • 1. Scotton WJ, Hill LJ, Williams AC, Barnes NM. Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions. International Journal of Tryptophan Research. 2019;12:1178646919873925.
  • 2. Özdemir S, Kocabaşoǧlu N. Serotonin Sendromuna Güncel Bir Yaklaşım. Klinik Psikofarmakoloji Bulteni. 2007;17(4).
  • 3. Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991;148(6):705-13.
  • 4. Dunkley E, Isbister G, Sibbritt D, Dawson A, Whyte I. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Qjm. 2003;96(9):635-42.
  • 5. Radomski J, Dursun S, Reveley M, Kutcher S. An exploratory approach to the serotonin syndrome: an update of clinical phenomenology and revised diagnostic criteria. Medical hypotheses. 2000;55(3):218-24.
  • 6. Coleman JJ, Pontefract SK. Adverse drug reactions. Clinical Medicine. 2016;16(5):481.
  • 7. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts E, et al. A method for estimating the probability of adverse drug reactions. Clinical Pharmacology & Therapeutics. 1981;30(2):239-45.
  • 8. Karunatilake H, Buckley NA. Serotonin syndrome induced by fluvoxamine and oxycodone. Annals of Pharmacotherapy. 2006;40(1):155-7.
  • 9. Ailawadhi S, Sung KW, Carlson L, Baer M. Serotonin syndrome caused by interaction between citalopram and fentanyl. Journal of clinical pharmacy and therapeutics. 2007;32(2):199- 202.
  • 10. Pan J-J, Shen WW. Serotonin syndrome induced by low-dose venlafaxine. Annals of Pharmacotherapy. 2003;37(2):209-11.
  • 11. Inaguma D, Kitagawa W, Hayashi H, Kanoh T, Kurata K, Kumon S. Three cases of severe hyponatremia under taking selective serotonin reuptake inhibitor (SSRI). Nihon Jinzo Gakkai Shi. 2000;42(8):644-8.
  • 12. Kirby D, Harrigan S, Ames D. Hyponatraemia in elderly psychiatric patients treated with selective serotonin reuptake inhibitors and venlafaxine: a retrospective controlled study in an inpatient unit. International journal of geriatric psychiatry. 2002;17(3):231-7.
  • 13. Oruch R, Pryme IF, Engelsen BA, Lund A. Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatric disease and treatment. 2017:161-75.
  • 14. Bartlett D. Drug-induced serotonin syndrome. Critical care nurse. 2017;37(1):49-54.
  • 15. Kan R, Endou M, Unno Y. A case of serotonin syndrome following minimum doses of sertraline. Seishin Shinkeigaku Zasshi=Psychiatria et Neurologia Japonica. 2009;111(9):1041-6.
  • 16. Gelener P, Gorgulu U, Kutlu G, Ucler S, Inan LE. Serotonin syndrome due to duloxetine. Clinical Neuropharmacology. 2011;34(3):127-8.
  • 17. Öztürk N, Ezgi K, Sözeri-Varma G, Değirmenci E. Düşük doz essitalopram ile serotonin sendromu. Journal of Mood Disorders. 2013;3(1):37-40.
  • 18. Stahl SM. Prescriber's guide: Antidepressants: Stahl's essential psychopharmacology: Cambridge University Press; 2017.
  • 19. George TP, Godleski LS. Possible serotonin syndrome with trazodone addition to fluoxetine. Biological psychiatry. 1996;39(5):384-5.
  • 20. Rao R. Serotonin syndrome associated with trazodone. International journal of geriatric psychiatry. 1997;12(1):129-30.
  • 21. Reeves RR, Bullen JA. Serotonin syndrome produced by paroxetine and low-dose trazodone. Psychosomatics: Journal of Consultation and Liaison Psychiatry. 1995.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Reports
Authors

Sare Aydın 0000-0002-5081-5983

Sedat Batmaz 0000-0003-0585-2184

Orhan Sümbül 0000-0001-7263-764X

Esma Akpınar Aslan 0000-0003-4714-6894

Publication Date September 23, 2023
Submission Date December 9, 2022
Acceptance Date July 3, 2023
Published in Issue Year 2023 Volume: 30 Issue: 3

Cite

Vancouver Aydın S, Batmaz S, Sümbül O, Akpınar Aslan E. FLUOKSETİN VE DÜŞÜK DOZ TRAZODONUN BİRLİKTE KULLANIMIYLA OLASI SEROTONİN SENDROMU DÜŞÜNDÜREN VE NARANJO İLAÇ YAN ETKİSİ OLASILIĞI ÖLÇEĞİ İLE DEĞERLENDİRİLEN BİR OLGU. Med J SDU. 2023;30(3):572-7.

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