Skip to main content
Journal of Accident & Emergency Medicine logoLink to Journal of Accident & Emergency Medicine
. 1999 Jul;16(4):293–295. doi: 10.1136/emj.16.4.293

Serotonin syndrome caused by overdose with paroxetine and moclobemide.

C R FitzSimmons 1, S Metha 1
PMCID: PMC1343379  PMID: 10417944

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.

Full text

PDF
293

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Gram L. Fluoxetine. N Engl J Med. 1994 Nov 17;331(20):1354–1361. doi: 10.1056/NEJM199411173312008. [DOI] [PubMed] [Google Scholar]
  3. 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]
  4. 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]
  5. 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]
  6. 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]
  7. 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]
  8. 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]
  9. 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]
  10. 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]

Articles from Journal of Accident & Emergency Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES