Sertraline
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Serotonin-syndrome: case report A 36-year-old man developed serotonin syndrome during treatment with sertraline for depression and post-traumatic stress disorder (PTSD). The man presented to emergency department (ED) with anxiety. He experienced various symptoms including flushing, headaches, chest pain, diaphoresis, palpitations, nausea/vomiting, diarrhoea and abdominal pain with one episode of fecal incontinence from the past two weeks. His vital signs included pulse rate of 68 beats/min, BP of 132/87 [unit not stated], RR of 18 breaths/min, body temperature of 98.8°F and oxygen saturation 98% on room air. Anamnesis revealed that he had been receiving treatment with sertraline 100mg daily [route not stated] from two to three months prior to presentation. Additionally, he was receiving treatment with hydroxyzine concomitantly. Physical examination showed inducible clonus with five beats at the ankle and 4+ deep tendon reflexes in his upper and lower extremities bilaterally. Based on these findings, clinical presentation and Hunter criteria, he was diagnosed with serotonin syndrome associated with sertraline [duration of treatment to reaction onset not clearly stated]. The man was treated with lorazepam and had immediate anxiety relief. Also, he was treated with sodium chloride [normal saline]. Subsequently, he was admitted and received an additional dose of lorazepam. However, he was discharged the following day with primary care follow up and instructions to discontinue sertraline. His symptoms resolved within 24 hours after discontinuation of sertraline, treatment with lorazepam and IV fluids. Duignan KM, et al. Serotonin syndrome from sertraline monotherapy. American Journal of Emergency Medicine 38: 1695e5-e6, No. 8, Aug 2020. Available from: URL: http:/ /doi.org/10.1016/j.ajem.2019.158487 803498231
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Reactions 29 Aug 2020 No. 1819
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