Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient.
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Date
2014-01
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Abstract
Serotonin syndrome causes confusion or altered mental status; other symptoms include myoclonus, shivering, tremors, diaphoresis, hyperreflexia, incoordination, fever and diarrhoea. Tramadol possesses dual pharmacological effects i.e., a weak opiate agonist at mu, kappa and delta opiate receptors along with reuptake inhibition of norepinephrine and serotonin. Risk associated with tramadol increases when co-administered with serotonergic antidepressants or MAOIs (monoamine oxidase inhibitors) and in renal impaired. The incidence of this syndrome is less than 1% as most of the cases remain unreported. The case highlights the fact that interaction between serotonergic agents like fluoxetine and tramadol especially in the presence of co-morbid medical illness can lead to serotonin syndrome.
Description
Keywords
Serotonin syndrome, SSRIs (Serotonin Reuptake Inhibitors), Opioids, Drug-drug interactions, CYP 450
Citation
Raj Rajnish, Kumar Raj, Sidhu Balwant Singh,Yakhami Saurabh. Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient. International Journal of Basic & Clinical Pharmacology. 2014 Jan-Feb; 3(1): 227-229.