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Related Experiment Videos

Serotonin syndrome and fluvoxamine: a case study

J B Bastani1, M M Troester, A J Bastani

  • 1Dept. of Psychiatry, Bryan Memorial Hospital, Lincoln, NE 68506, USA.

The Nebraska Medical Journal
|April 1, 1996
PubMed
Summary

A patient developed serotonin syndrome after switching to fluvoxamine (a selective serotonin reuptake inhibitor) from another SSRI. Discontinuation of fluvoxamine led to recovery, highlighting a potential risk.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Pharmacology

Background:

  • Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and obsessive-compulsive disorder (OCD).
  • Fluvoxamine is an SSRI used to treat Depressive Disorder and OCD, often as a replacement or potentiator for other SSRIs.
  • While generally well-tolerated, SSRIs carry a risk of adverse effects, including serotonin syndrome.

Observation:

  • A patient with OCD, previously treated with paroxetine, was switched to fluvoxamine.
  • Following dose adjustments of fluvoxamine, the patient experienced suicidal ideation, concentration difficulties, low-grade fever, and auditory hallucinations.
  • These symptoms resolved within 24 hours of discontinuing fluvoxamine.

Findings:

  • The patient's clinical presentation was consistent with serotonin syndrome.
  • The adverse event appeared to be directly related to the introduction and titration of fluvoxamine.
  • Discontinuation of fluvoxamine led to a rapid and complete recovery.

Implications:

  • This case highlights the potential risk of serotonin syndrome when switching patients between different SSRIs, specifically involving fluvoxamine.
  • Clinicians should be vigilant for signs of serotonin syndrome in patients initiating or titrating fluvoxamine, especially those with a history of SSRI use.
  • Further awareness and careful patient monitoring are crucial to mitigate this risk during SSRI treatment transitions.

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