Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T20:40:22.892Z Has data issue: false hasContentIssue false
  • English
  • Français

Serotonin syndrome due to an overdose of moclobemide?

Published online by Cambridge University Press:  21 May 2015

Andrew Ip  and
Tia Renouf
Andrew Ip*
Affiliation:
Department of Emergency Medicine, St. Paul’s Hospital, Vancouver, BC
Tia Renouf
Affiliation:
Department of Emergency Medicine, Health Sciences Centre, Memorial University of Newfoundland, St. John’s, Nfld
*
Department of Emergency Medicine, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC V6Z 1Y6; 604 806-8986, fax 604 806-8798, [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Serotonin syndrome, a triad of autonomic instability, altered mental status and neuromuscular abnormalities, is usually attributed to serotonergic overdoses. Moclobemide is a new selective monoamine oxidase inhibitor (MAOI) that generally causes mild, self-limited gastrointestinal and central nervous system effects after ingestion. We present a case of serotonin syndrome that occurred after moclobemide overdose, and discuss the recognition and treatment of this important condition. Serotonin syndrome may become increasingly common because of the liberal use of selective serotonin reuptake inhibitors, new MAOIs and other agents such as codeine and meperidine, which have the potential for harmful interaction.

Keywords

serotoninserotonin syndromemonoamine oxidase inhibitormoclobemidecodeineFiorinaloverdoseingestion
Type
Toxicology • Toxicologie
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 2 , March 2002 , pp. 98 - 101
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

References

1.Fitzsimmons, CR, Metha, S.Serotonin syndrome caused by overdose with paroxetine and moclobemide. J Accid Emerg Med 1999;16:293–5.Google Scholar
2.Martin, TG.Serotonin syndrome [review]. Ann Emerg Med 1996;28:520–6.CrossRefGoogle ScholarPubMed
3.Francois, B, Marquet, P, Desachy, A, Roustan, J, Lachatre, G, Gastinne, H.Serotonin syndrome due to an overdose of moclobemide and clomipramine. A potentially life-threatening association. Intensive Care Med 1997;23:122–4.Google Scholar
4.Gill, M, LoVecchio, F, Selden, B.Serotonin syndrome in a child after a single dose of fluvoxamine. Ann Emerg Med 1999; 33(4):457–9.CrossRefGoogle Scholar
5.Kolecki, P.Isolated venlafaxine-induced serotonin syndrome. J Emerg Med 1997;15:491–3.Google Scholar
6.Kuisma, M.Fatal serotonin syndrome with trismus. Ann Emerg Med 1995;26:108.Google Scholar
7.Tueth, MJ.The serotonin syndrome in the emergency department. Ann Emerg Med 1993;22:1369.CrossRefGoogle ScholarPubMed
8.Daniels, RJ.Serotonin syndrome due to venlafaxine overdose. J Accid Emerg Med 1998;15:333–4.CrossRefGoogle ScholarPubMed
9.Kaminski, CA, Robbins, MS, Weibley, RE.Sertraline intoxication in a child. Ann Emerg Med 1994;23:1371–4.Google Scholar
10.Hernandez, AF, Montero, MN, Pla, A, Villanueva, E.Fatal moclobemide overdose or death caused by serotonin syndrome? J Forensic Sci 1995;40:128–30.CrossRefGoogle ScholarPubMed
11.Mullins, ME, Horowitz, BZ.Serotonin syndrome after a single dose of fluvoxamine. Ann Emerg Med 1999;34:806–7.Google Scholar
12.Neuvonen, PJ, Pohjola-Sintonen, S, Tacke, U, Vuori, E.Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses. Lancet 1993;342:1419.Google Scholar
13.Sternbach, H.The serotonin syndrome [review]. Am J Psychiatry 1991;148:705–13.Google ScholarPubMed
14.Mueller, PD, Korey, WS.Death by “ecstasy”: the serotonin syndrome? Ann Emerg Med 1998;32(3 Pt 1):377–80.CrossRefGoogle ScholarPubMed
15.Hilton, SE, Maradit, H, Moller, HJ.Serotonin syndrome and drug combination: focus on MAOI and RIMA [review]. Eur Arch Psychiatry Clin Neurosci 1997;247:113–9.CrossRefGoogle ScholarPubMed
16.Power, BM, Pinder, M, Hackett, LP, Ilett, KF.Fatal serotonin syndrome following a combined overdose of moclobemide, clomipramine and fluoxetine. Anaesth Intensive Care 1995; 23:499–502.CrossRefGoogle ScholarPubMed
17.Roxanas, MG, Machado, JF.Serotonin syndrome in combined moclobemide and venlafaxine ingestion. Med J Austr 1998; 168:523–4.CrossRefGoogle ScholarPubMed
18.Ruiz, F.fluoxetine and the serotonin syndrome. Ann Emerg Med 1994;24:983–5.CrossRefGoogle ScholarPubMed
19.Graudins, A, Stearman, A, Chan, B.Treatment of the serotonin syndrome with cyproheptadine. J Emerg Med 1998;16(4):615–9.Google Scholar
20.Gillman, PK.Ecstasy, serotonin syndrome, and the treatment of hyperpyrexia. Med J Austr 1997;167:109,111.CrossRefGoogle ScholarPubMed
21.Halman, M, Goldbloom, DS.Fluoxetine and neuroleptic malignant syndrome. Biol Psychiatry 1990;28:518–21.Google Scholar