Conversion disorder mimicking serotonin syndrome in an adolescent taking sertraline.

We present the case of a 15-year-old-boy on sertraline (Zoloft) who presented to the Emergency Department with palpitations, tremor, and weakness after starting erythromycin. Upon admission to the hospital, he developed syncopal-like episodes of unresponsiveness associated with body-wide jerking and stiffening as well as tachycardia and hypertension. He was initially believed to have serotonin syndrome and was transferred to a pediatric Intensive Care Unit where the diagnosis of conversion disorder was made. We discuss the salient features of serotonin syndrome and conversion disorder and emphasize the importance of making either diagnosis.