Varma Samyukta, Xavier Sona, Desai Saral, Ali Syed
Internal Medicine, Madurai Medical College, Madurai, IND.
Psychiatry, Jackson Park Hospital, Chicago, USA.
Cureus. 2022 Aug 4;14(8):e27668. doi: 10.7759/cureus.27668. eCollection 2022 Aug.
Serotonin syndrome (SS) is a potentially life-threatening condition caused by drugs that act on serotonergic receptors or alter serotonin metabolism. We present a case of SS in a middle-aged female who was taking trazodone and sertraline as her home medications and developed SS after being started on quetiapine during her hospital course. A 54-year-old female with a past medical history of dementia and bipolar disorder was brought to the emergency department from a nursing home for altered mental status. Delirium was ruled out. Initial blood work was significant for an elevated creatine phosphokinase (CPK) level of 753 U/L. She was started on Quetiapine 100 mg bis in die (BID) after admission as she had a history of bipolar disorder and she was having acute mood symptoms (impulsive, irritable, confrontational, belligerent, and unable to be redirected). On the second day of admission, the patient started having diaphoresis, tremors, hyperreflexia, myoclonus, and ocular clonus. A diagnosis of SS was made using Hunter's criteria. All serotonergic medications were discontinued after which the patient started improving. She was also started on supportive therapy including IV fluids, lorazepam, and cyproheptadine. The patient was discharged on the fourth day of admission.
血清素综合征（SS）是一种由作用于血清素能受体或改变血清素代谢的药物引起的潜在危及生命的病症。我们报告一例中年女性的血清素综合征病例，该患者在家服用曲唑酮和舍曲林，在住院期间开始服用喹硫平后发生血清素综合征。一名有痴呆和双相情感障碍病史的54岁女性从养老院被送往急诊科，原因是精神状态改变。排除了谵妄。初始血液检查显示肌酸磷酸激酶（CPK）水平显著升高，为753 U/L。入院后，由于她有双相情感障碍病史且出现急性情绪症状（冲动、易怒、好斗、挑衅且无法被转移注意力），开始给予喹硫平100 mg每日两次（BID）。入院第二天，患者开始出现多汗、震颤、反射亢进、肌阵挛和眼球阵挛。根据亨特标准做出了血清素综合征的诊断。停用所有血清素能药物后，患者开始好转。她还开始接受包括静脉输液、劳拉西泮和赛庚啶在内的支持治疗。患者在入院第四天出院。
