Selective serotonin reuptake inhibitors induced serotonin syndrome – A case report

Abstract

Serotonin syndrome also known as serotonin toxicity is a potentially life threatening  syndrome that is precipitated due to excess serotonin within CNS. It results in variety of mental, autonomic and neuromuscular changes which ranges in severity from mild to fatal. It is nearly always caused by drug interaction involving two or more serotonergic drugs atleast one which is SSRIs. This is a case of 35- year- old female patient, admitted to hospital with 2 episodes of seizures, fever, headache, depression and was put on sodium valproate, clonazepam+escitalopram, paracetamol, sertraline. The patient medical history reveals that she is a known case of major depression and syncopal attack and was on escitalopramoxolate from 1 year. After two days of therapy patient developed tremors, restlessness, muscle rigidity, shivering and was clonus. On examination, variation in vitals was noticed and diagnosed as serotonin syndrome by review of medication chart sertraline was stopped and lorazepam was administered and patient showed good response and felt better. Proper education and awarness about drugs, drug-drug interaction causing SS its accuracy of diagnosis that prevents morbitiy and mortality in patients prescribed with SSRIs is of utmost importance.