Reactions 962 - 2 Aug 2003

SCitalopram/fluoxetine

Serotonin syndrome: 2 case reportsA man and a woman, both aged 50 years, developed

serotonin syndrome while receiving fluoxetine and citalopram,respectively [therapeutic indications and duration of treatmentnot stated].

The man had recently had his fluoxetine dose increased to120 mg/day when he was hospitalised with hyperhidrosis,nausea, vomiting and diarrhoea. On admission he wasagitated, had insomnia and hyper-reflexia, a HR of 96beats/min, a BP of 155/80mm Hg and a respiratory rate of 20breaths/min. A diagnosis of serotonin syndrome was made andhis medication was discontinued. He received electrolytes,metoclopramide and dipotassium clorazepate and his nausea,vomiting, hyperhidrosis and diarrhoea resolved within 72hours. His agitation resolved more slowly and he wasdischarged after 5 days.

The woman was receiving citalopram 20 mg/day when shewas hospitalised with agitation, insomnia and tremors. Onadmission her HR was 130 beats/min, her BP was 135/70mmHg, her respiratory rate was 32 breaths/min and she wasconfused, had hyperhidrosis, hyper-reflexia and myoclonus. Adiagnosis of serotonin syndrome was made and citalopramoverdose was suspected. Her medication was discontinued,she received electrolytes and her condition improvedsufficiently for her to be discharged 24 hours later.Birmes P, et al. Serotonin syndrome: a brief review. CMAJ: Canadian MedicalAssociation Journal 168: 1439-1442, 27 May 2003 - France 800946001

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Reactions 2 Aug 2003 No. 9620114-9954/10/0962-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved