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Published on: April 18, 2011
Serotonin syndrome from combination hydrocodone and cyclobenzaprine in a patient with cerebral palsy
Vishal Bansal1, Mayank Aranke1, Peter Vu1
1McGovern Medical School at The University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA.
Abstract:
Aim: Serotonin syndrome (SS) is a life-threatening syndrome that occurs with the use of serotonergic drugs, most commonly due to two or more agents. Cerebral palsy is associated with mood disorders, and more commonly pain, with a prevalence of up to 50-80%. Case presentation: A 58-year-old female with cerebral palsy, metastatic malignancy and mood disorder who presented to the emergency department with acute-on-chronic pain, and signs of SS. She was initiated on iv. dilaudid, titrated off oral medications and scheduled for a left-sided sacroiliac joint injection. Results: It was suspected that due to additional doses of hydrocodone and cyclobenzaprine, she developed moderate-SS. Conclusion: Physicians need to be cognizant of comorbidities and uncommon pain medications that can predispose patients to SS.
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