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Serotonin syndrome and neuroleptic malignant syndrome: A case report of intersecting symptomatology.
Maktabi, Loulwa; Shipman, Denver; Reinert, Justin P.
Afiliación
  • Maktabi L; Visiting Assistant Clinical Professor & Clinical Pharmacist, The University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio.
  • Shipman D; Clinical Pharmacy Specialist, The Robert J. Dole Veteran Affairs Medical Center, Wichita, Kansas.
  • Reinert JP; Visiting Assistant Clinical Professor & Clinical Pharmacist, The University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio.
Ment Health Clin ; 14(1): 23-27, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38312440
ABSTRACT

Introduction:

Serotonin syndrome and neuroleptic malignant syndrome are caused by 2 distinct pathologies; however, the clinical presentation associated with both syndromes share many features.

Methods:

We describe a 56-year-old male patient who presented to our facility with seizures, leukocytosis, fevers, extremity hyperreflexia, and signs of autonomic dysfunction as evidenced by cardiovascular instability. The patient was noted to be taking vortioxetine, trazodone, lamotrigine, lurasidone, and carbidopa-levodopa as outpatient medications for his depression, an unspecified mood disorder, and Parkinson disease. Following a robust workup and failure of other therapies, all serotonergic and dopaminergic medications were held, and the patient was tried on cyproheptadine for serotonin syndrome, which led to the cessation of fevers. Bromocriptine was added to the regimen, which led to the resolution of the remainder of the patient's symptoms.

Results:

The overlapping symptomatology of several key diagnostic criteria for both serotonin syndrome and neuroleptic malignant syndrome as well as their nature as diagnoses of exclusion require an evaluation of the patient's aggregate improvement following targeted pharmacologic strategies for both syndromes. The efficacy of both cyproheptadine and bromocriptine when administered concomitantly support the concurrent pathologies.

Discussion:

Clinicians at the bedside must be cognizant of the potential for clinically relevant drug-drug interactions that may present with overlapping pathologies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: Ment Health Clin Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: Ment Health Clin Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos