Reactions 1704, p270 - 2 Jun 2018 X S Serotonin syndrome: case report A 69-year-old woman developed mild serotonin syndrome, which manifested as akathisia during concurrent administration of escitalopram, gabapentin, lorazepam, mirtazapine, olanzapine and trazodone [routes and dosages not stated]. The woman was admitted due to hypoxic respiratory failure secondary to chronic heart failure. Her medical history was significant for hypertension, hyperlipidaemia, COPD, anxiety and Alzheimer’s dementia. Geriatrics was consulted for suspected delirium. At the time of examination, she was agitated and was repeatedly asking to be repositioned with pleas of "help me, help me." Her collateral history confirmed the behaviour as chronic and difficult to treat, which had further resulted in a complex drug regimen. She was receiving lorazepam, trazodone, escitalopram, mirtazapine, gabapentin, and olanzapine. She was diagnosed with mild serotonin syndrome and akathisia was considered as its primary manifestation. Her akathisia was related to mild serotonin syndrome. The woman’s treatment with mirtazapine was weaned off, and the doses of escitalopram, trazodone and olanzapine were decreased. Lorazepam was continued on a low dose to prevent drug withdrawal symptoms. Subsequent improvement was noted in her akathisia [time to reactions onset not stated]. Author comment: "Despite all of her medications having the best safety profiles of their class, the combination likely precipitated a mild serotonin syndrome with akathisia as the primary manifestation." Walia R, et al. When the solution becomes the problem: The dangers of a prescribing cascade. Journal of the American Geriatrics Society 66 (Suppl. 2): S104 (plus poster) abstr. B32, Apr 2018. Available from: URL: http:// doi.org/10.1111/jgs.15376 [abstract] - USA 803323430 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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