Key result
Metoclopramide induced serotonin syndrome in a 40-year-old woman taking mirtazapine, which resolved following three days of treatment with oral lorazepam and cyproheptadine.
Why the study?
Does metoclopramide induce serotonin syndrome in patients taking mirtazapine?
Case Report (n=1)
Does metoclopramide induce serotonin syndrome in patients taking mirtazapine?
Answers are grounded in this paper and cite their sources.
Metoclopramide can induce potentially fatal serotonin syndrome when used concomitantly with other serotonergic agents.
A 40-year-old woman with bipolar disorder who was taking mirtazapine presented with mydriasis, abnormal diaphoresis, myoclonus and muscle rigidity after taking metocloplamide. Her medical history, which included the use of serotonergic agents, and the presence of symptoms including myoclonus and muscle rigidity were consistent with a diagnosis of serotonin syndrome (SS) according to the Hunter criteria. The symptoms diminished following three days of treatment with oral lorazepam and cyproheptadine and a reduced dose of mirtazapine. Metoclopramide is frequently used to various gastric symptom. Metoclopramide is not widely known to induce SS. This potentially fatal condition should be avoided by exercising care in the use of drugs that have the potential to cause drug-drug interactions.
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Harada et al. (2017) conducted a case report in Serotonin Syndrome (n=1). Metoclopramide was evaluated on Serotonin syndrome. Metoclopramide induced serotonin syndrome in a 40-year-old woman taking mirtazapine, which resolved following three days of treatment with oral lorazepam and cyproheptadine.
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