Serotonin Syndrome after Lithium Add-on Medication to Paroxetine
1997; Thieme Medical Publishers (Germany); Volume: 30; Issue: 03 Linguagem: Inglês
10.1055/s-2007-979491
ISSN1439-0795
AutoresThomas Sobanski, M. Bagli, Gerd Laux, M. Sudhakar Rao,
Tópico(s)Treatment of Major Depression
ResumoA 59-year-ld female patient was hospitalized on account of a depressive episode in the course of a long-standing bipolar disorder. On a combination of lithium (400 mg/day) and paroxetine (30 mg/day) she developed symptoms of shivering, high-frequency tremor of the upper and lower limbs, skin flush in the face, agitation, and slight impairment of mental focusing, suggestive of a serotonin syndrome. At this stage serum lithium and paroxetine levels were 0.63 mmol/l, and 693 ng/ml, respectively; the latter was six times higher than the upper concentrations seen in patients on this dosage of the drug. Consequently, the dosage of paroxetine was reduced to 10 mg/day, and lithium was continued. This regimen resulted in a steady-state paroxetine serum level of 390 ng/ml. The patient became symptom-free and the depressive episode attenuated, thus enabling us to discharge the patient.
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