Serotonin Syndrome With Paroxetine Overdose

Abstract

PSYCHIATRIST.COM Method. The data derived from a retrospective study investigating demographic characteristics, diagnosis, and medication of all inpatients between August 1, 2002, and August 31, 2004, who were admitted to the Department of Child and Adolescent Psychiatry of Innsbruck Medical University. Seventy inpatients were prescribed drugs for the time after discharge. Data about further drug intake, consultations (psychiatrist or general practitioner), and weight gain were evaluated by follow-up interviews. Twenty-two of the 70 could not be contacted or were not willing to give any further information, and 48 patients were included in the study. Their mean ± SD age was 15.8 ± 1.7 years (range, 10-18 years), 23 (48%) were male, and 25 (52%) were female. According to DSM-IV criteria, 8 (17%) were diagnosed with schizophrenia, 22 (46%) with mood disorders (including adjustment disorders), 11 (23%) with disruptive behavior disorders, and 7 (15%) had other diagnoses (misuse of psychoactive substances, mental retardation, personality disorders, and development disorders). They were treated with antipsychotics (48%, N = 23; risperidone, olanzapine, clozapine, quetiapine, amisulpride, and ziprasidone) and antidepressants (52%, N = 25; citalopram, mirtazapine, fluoxetine, sertraline, escitalopram, trazodone, and venlafaxine).The effects of age, gender, time since discharge (≤ 6 months, 46%; > 6 months, 54%), weight gain (< 5 kg versus ≥ 5 kg), and pharmacologic treatment (antidepressant versus antipsychotic) on adherence were investigated by means of logistic regression with backward variable selection. The same method was applied to analyze the effects of the above-mentioned variables on weight gain. Odds ratios were calculated to quantify the effect of the potential risk factors. The logistic regression was supplemented by bivariate analyses of the associations between adherence and the individual potential risk factors using Fisher exact test.Results. Forty-six of 48 patients took part in follow-up consultations. Twenty-two patients continued the drug intake at the point of the interview, 12 had discontinued the drug intake after consulting their psychiatrist or general practitioner, and 12 had discontinued without consulting. These 12 patients were classified as noncompliant.When considering the effects of age, gender, time since discharge, weight gain, and pharmacologic treatment on adherence one by one, 2 variables were found to significantly increase the probability of nonadherence, namely, antidepressive treatment (p = .017) and diagnostic group (mood disorders versus all other diagnoses, p < .001). However, when investigating the potential risk factors jointly by logistic regression, only the effect of the diagnostic group remained significant (odds ratio = 26.4, p = .003, logistic regression), whereas the significance of antidepressive treatment disappeared (odds ratio = 4.33, p = .122, logistic regression). Obviously, the difference in adherence rate between patients with and without antidepressive treatm...

Deaths involving serotonergic drugs

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Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient

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Rare case of severe serotonin syndrome leading to bilateral compartment syndrome

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