Abstract
Well known clinical syndromes can be produced by overdose with more commonly ingested substances such as opiates or tricyclic antidepressants. A case of a much more unusual syndrome presenting to the accident and emergency department resulting from overdose with a combination of tablets is reported. The clinical presentation of serotonin syndrome and its management are described. This resulted from acute ingestion of paroxetine, a selective serotonin reuptake inhibitor, and moclobemide, a monoamine oxidase inhibitor.
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Selected References
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- Finley P. R. Selective serotonin reuptake inhibitors: pharmacologic profiles and potential therapeutic distinctions. Ann Pharmacother. 1994 Dec;28(12):1359–1369. doi: 10.1177/106002809402801207. [DOI] [PubMed] [Google Scholar]
- Gram L. Fluoxetine. N Engl J Med. 1994 Nov 17;331(20):1354–1361. doi: 10.1056/NEJM199411173312008. [DOI] [PubMed] [Google Scholar]
- Kam P. C., Chang G. W. Selective serotonin reuptake inhibitors. Pharmacology and clinical implications in anaesthesia and critical care medicine. Anaesthesia. 1997 Oct;52(10):982–988. doi: 10.1111/j.1365-2044.1997.162-az0176.x. [DOI] [PubMed] [Google Scholar]
- Kincaid R. L., McMullin M. M., Crookham S. B., Rieders F. Report of a fluoxetine fatality. J Anal Toxicol. 1990 Sep-Oct;14(5):327–329. doi: 10.1093/jat/14.5.327. [DOI] [PubMed] [Google Scholar]
- Neuvonen P. J., Pohjola-Sintonen S., Tacke U., Vuori E. Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses. Lancet. 1993 Dec 4;342(8884):1419–1419. doi: 10.1016/0140-6736(93)92774-n. [DOI] [PubMed] [Google Scholar]
- Rohrig T. P., Prouty R. W. Fluoxetine overdose: a case report. J Anal Toxicol. 1989 Sep-Oct;13(5):305–307. doi: 10.1093/jat/13.5.305. [DOI] [PubMed] [Google Scholar]
- Singer P. P., Jones G. R. An uncommon fatality due to moclobemide and paroxetine. J Anal Toxicol. 1997 Oct;21(6):518–520. doi: 10.1093/jat/21.6.518. [DOI] [PubMed] [Google Scholar]
- Spigset O., Mjörndal T., Lövheim O. Serotonin syndrome caused by a moclobemide-clomipramine interaction. BMJ. 1993 Jan 23;306(6872):248–248. doi: 10.1136/bmj.306.6872.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sporer K. A. The serotonin syndrome. Implicated drugs, pathophysiology and management. Drug Saf. 1995 Aug;13(2):94–104. doi: 10.2165/00002018-199513020-00004. [DOI] [PubMed] [Google Scholar]
- Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991 Jun;148(6):705–713. doi: 10.1176/ajp.148.6.705. [DOI] [PubMed] [Google Scholar]
