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    Neurol Sci. 2011 Jun;32(3):507-9. doi: 10.1007/s10072-011-0546-z. Epub 2011 Apr 14.

    Serotonin toxicity: a short review of the literature and two case reports involving citalopram.

    Source

    Memory Clinic, Department of Neurological Science, University La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.

    Abstract

    The serotonin toxicity (ST) is a potentially life-threatening adverse drug reaction results from therapeutic drug use, intentional self-poisoning, or inadvertent interactions between drugs. ST can be caused by a single or a combination of drugs with serotonergic activity due to excessive serotonergic agonism on central nervous system and peripheral serotonergic receptors (monoamine oxidase inhibitors, tricyclic antidepressants, SSRIs, opiate analgesics, over-the-counter cough medicines, antibiotics, weight-reduction agents, antiemetics, antimigraine agents, drugs of abuse, H2-antagonist and herbal products). The serotonin toxicity is often described as a clinical triad of mental-status changes (agitation and excitement with confusion), autonomic hyperactivity (diaphoresis, fever, tachycardia, and tachypnea), neuromuscular abnormalities (tremor, clonus, myoclonus, and hyperreflexia) and, in the advanced stage, spasticity; not all of these findings are consistently present. In this article, we describe two cases of ST due to interaction between Citalopram and two CYP2D6 inhibitors: Cimetidine and Topiramate and their clinical resolution after treatment discontinuation.

    PMID:
    21491099
    [PubMed - indexed for MEDLINE]

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