Possible Serotonin Syndrome Associated with Buspirone Added to Fluoxetine

Manos, Gail H.

doi:10.1345/aph.19341

Cited by 31 publications

(14 citation statements)

References 22 publications

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“…Although linezolid appeared to be effective in clinical trials and in numerous case reports for the treatment of various infections with gram-positive organisms [2][3][4][5][6], recent letters from prescribers and the manufacturer report that prolonged use of linezolid can lead to myelosuppression, including neutropenia, thrombocytopenia, and anemia [7]. According to a review by Kuter and Tillotson [7], many patients who developed severe myelosuppression in postmarketing surveillance were at increased risk for preexisting cytopenia or had decreased bone marrow reserve.…”

mentioning

confidence: 99%

Myelosuppression and Serotonin Syndrome Associated with Concurrent Use of Linezolid and Selective Serotonin Reuptake Inhibitors in Bone Marrow Transplant Recipients

Hachem

Hicks

Huen

et al. 2003

Clinical Infectious Diseases

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We report 2 cases of serotonin syndrome and myelosuppression in bone marrow transplant recipients who received linezolid in combination with a selective serotonin reuptake inhibitor (SSRI). Given the risks to patients in this high-risk group, we recommend that this combination of medications be avoided if alternative antibiotic therapy is possible. If no alternative therapy is possible, prescribers should discontinue SSRI therapy and monitor these patients closely for evidence of serotonin syndrome or the development of hematological toxicity.

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confidence: 99%

Myelosuppression and Serotonin Syndrome Associated with Concurrent Use of Linezolid and Selective Serotonin Reuptake Inhibitors in Bone Marrow Transplant Recipients

Hachem

Hicks

Huen

et al. 2003

Clinical Infectious Diseases

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“…Several case studies have reported the development of serotonin toxicity by the combined use of SSRIs and 5-HT1A agonist anxiolytics;20,21 however, high body temperatures were not observed in these studies. The exacerbation of serotonin toxicity in the present cases by adding small doses of paroxetine while administering perospirone – acting both as a 5-HT1A receptor agonist and a 5-HT2A receptor antagonist – clearly indicates the involvement of the 5-HT1A receptor in mild forms of serotonin toxicity.…”

Section: Discussionmentioning

confidence: 81%

Two cases of mild serotonin toxicity via 5-hydroxytryptamine 1A receptor stimulation

Nakayama¹,

Umeda²,

Nibuya³

et al. 2014

NDT

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We propose the possibility of 5-hydroxytryptamine (5-HT)1A receptor involvement in mild serotonin toxicity. A 64-year-old woman who experienced hallucinations was treated with perospirone (8 mg/day). She also complained of depressed mood and was prescribed paroxetine (10 mg/day). She exhibited finger tremors, sweating, coarse shivering, hyperactive knee jerks, vomiting, diarrhea, tachycardia, and psychomotor agitation. After the discontinuation of paroxetine and perospirone, the symptoms disappeared. Another 81-year-old woman, who experienced delusions, was treated with perospirone (8 mg/day). Depressive symptoms appeared and paroxetine (10 mg/day) was added. She exhibited tachycardia, finger tremors, anxiety, agitation, and hyperactive knee jerks. The symptoms disappeared after the cessation of paroxetine and perospirone. Recently, the effectiveness of coadministrating 5-HT1A agonistic psychotropics with selective serotonin reuptake inhibitors (SSRIs) has been reported, and SSRIs with 5-HT1A agonistic activity have been newly approved in the treatment of depression. Perospirone is a serotonin–dopamine antagonist and agonistic on the 5-HT1A receptors. Animal studies have indicated that mild serotonin excess induces low body temperature through 5-HT1A, whereas severe serotonin excess induces high body temperature through 5-HT2A activation. Therefore, it could be hypothesized that mild serotonin excess induces side effects through 5-HT1A, and severe serotonin excess induces lethal side effects with hyperthermia through 5-HT2A. Serotonin toxicity via a low dose of paroxetine that is coadministered with perospirone, which acts agonistically on the 5-HT1A receptor and antagonistically on the 5-HT2A receptor, clearly indicated 5-HT1A receptor involvement in mild serotonin toxicity. Careful measures should be adopted to avoid serotonin toxicity following the combined use of SSRIs and 5-HT1A agonists.

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“…Recent case reports have suggested that there is a risk of the serotonin syndrome when SSRIs are combined with buspirone [36]. Recent case reports have suggested that there is a risk of the serotonin syndrome when SSRIs are combined with buspirone [36].…”

Section: Selective Serotonin Re-uptake Inhibitors (Ssris)mentioning

confidence: 99%

Buspirone

2016

Meyler's Side Effects of Drugs

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Possible Serotonin Syndrome Associated with Buspirone Added to Fluoxetine

Abstract: Symptoms consistent with serotonin syndrome may develop with the concurrent administration of buspirone and fluoxetine.

Cited by 31 publications

References 22 publications

Myelosuppression and Serotonin Syndrome Associated with Concurrent Use of Linezolid and Selective Serotonin Reuptake Inhibitors in Bone Marrow Transplant Recipients

Myelosuppression and Serotonin Syndrome Associated with Concurrent Use of Linezolid and Selective Serotonin Reuptake Inhibitors in Bone Marrow Transplant Recipients

Two cases of mild serotonin toxicity via 5-hydroxytryptamine 1A receptor stimulation

Buspirone

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