Why the study?
Does the addition of erythromycin to sertraline cause serotonin syndrome in a pediatric patient?
Does the addition of erythromycin to sertraline cause serotonin syndrome in a pediatric patient?
Clinicians should be aware of the pharmacokinetic interaction between erythromycin and sertraline, which can precipitate serotonin syndrome.
Alerts to possible CYP3A4 interaction with erythromycin and sertraline; single case leaves open broader risk and pediatric applicability.
Serotonin syndrome is an uncommon, serious adverse reaction that is usually associated with the interaction of two or more serotonergic agents. A 12-year-old boy receiving sertraline developed the syndrome after erythromycin was added to his regimen. The proposed mechanism involves erythromycin inactivation of cytochrome P450 3A4 inhibition of sertraline metabolism, accumulation of the drug, and precipitation of the syndrome. It is important for clinicians to consider both pharmacokinetic and pharmacodynamic interactions to minimize the risk of the reaction.
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Lee et al. (1999) studied this question.
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