Key result
Minimum-dose fluvoxamine followed by paroxetine linked to reversible serotonin syndrome in spinal cord injury.
Case Report (n=1)
Highlights the risk of serotonin syndrome even with minimum doses of SSRI monotherapy in patients with spinal cord injury.
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Clinicians should exercise caution with low-dose SSRIs in spinal cord injury; single case leaves association hypothesis-generating.
There have been only a few reports of serotonin syndrome developing after mono-therapy with a selective serotonin reuptake inhibitor (SSRI). We report a case of serotonin syndrome caused by long-term therapy with fluvoxamine prior to treatment with paroxetine. An 18-year-old man with spinal cord injury (SCI) at thoracic level 2-3 presented with onset of serotonin syndrome after taking fluvoxamine (50 mg per day) for 8 weeks prior to treatment with paroxetine (10 mg per day) for 6 days. He had confusion, agitation, severe headache, tachycardia (124 beats/minute), hypertension (165/118 mmHg), high fever (39.1 degrees C), and myoclonus. All of the symptoms disappeared within 24 hours after discontinuation of administration of paroxetine. This is an interesting case of serotonin syndrome that developed after minimum doses of single therapy with an SSRI in a patient with SCI.
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Satoh et al. (2006) conducted a case report in Serotonin syndrome in spinal cord injury (n=1). Fluvoxamine followed by paroxetine was evaluated on Development of serotonin syndrome. An 18-year-old man with a spinal cord injury developed serotonin syndrome after receiving minimum doses of fluvoxamine followed by paroxetine, which resolved within 24 hours of discontinuation.
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