Key result
Electroconvulsive therapy triggered serotonin syndrome in a patient with refractory depression in the absence of escalation of serotonergic medical therapy.
Case Report (n=1)
Electroconvulsive therapy may trigger serotonin syndrome without escalation of serotonergic medications, potentially due to blood-brain barrier changes.
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ECT may trigger serotonin syndrome without serotonergic escalation; single case leaves open causality and generalizability.
Serotonin syndrome is a toxicological entity with potential morbidity and mortality if unrecognized and untreated. Toxicity can occur after dose or increase or initiation of additional serotonergic medication, but can also be idiopathic. We report a case in which serotonin syndrome occurred after electroconvulsive therapy in the absence of escalation of medical therapy, and theorize a pathophysiologic mechanism based on basic science of blood–brain barrier integrity change after ECT.
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Herrington et al. (2018) conducted a case report in Refractory depression (n=1). Electroconvulsive therapy was evaluated on Serotonin syndrome. Electroconvulsive therapy triggered serotonin syndrome in a patient with refractory depression in the absence of escalation of serotonergic medical therapy.
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