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Ann Emerg Med. 1997 Feb;29(2):287-9.

Serotonin syndrome associated with nefazodone and paroxetine.

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  • 1Department of Pharmacy, Ottawa General Hospital, Ontario, Canada.


A 51-year-old woman was brought to the emergency department unresponsive, hyponatremic, and diaphoretic, with muscle rigidity. Her condition improved dramatically after supportive treatment and dantrolene. The patient had received nefazodone for 6 months, but the drug had been discontinued 2 days before admission after a tapering period. One day before admission, paroxetine 20 mg/day was started. A repeat challenge with paroxetine 7 days after discontinuation of nefazodone did not result in recurrence of the patient's symptoms. We believe this to be the first report of serotonin syndrome associated with nefazodone and paroxetine.

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