Famotidine-induced reversal of meperidine-related serotonin syndrome: a case report

Abstract

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.

Current Prescription Status of Contraindicated Drug Combinations Causing Serotonin Syndrome: Analysis of HIRA-NPS Data

“…To date, most studies on serotonin syndrome have been case-based in Korea. [23][24][25] To the best of our knowledge, there are no prior studies examining the prescribing status of contraindicated drug combinations that have the potential to cause serotonin syndrome in Korea. Therefore, we aimed to analyze the prescribing status of contraindicated serotonergic drug combinations using nationally representative data and to identify factors influencing this.…”