We report two cases of serotonin syndrome in depressed patients treated with a tricyclic antidepressant alone. One case was a 54-year-old woman hospitalized for major depression. The patient was prescribed with amitriptyline plus diazepam, and
presented
diarrhea, tremor, incoordination, rigidty and tachycardia. The other case was a 27-year-old man who was medicated with imipramine alone for depression, and showed fever, diaphoresis, hypomania, palpitation and tachycardia.
Most antidepressants interact with serotonin. Some side effects of antidepressants seem to be related to an increase in serotonin. Recently, it has been suggested that the association of mental status changes(confusion, hypomania), agitation,
myoclonus,
hyperreflexia, diaphoresis, shivering, tremor, diarrhea, incoordination and fever, in patients treated with serotoninergic agents, could constitute a 'serotonin syndrome'. The serontonin syndrome typically appears to be a selflimited condition
that
resolves quickly with offending agents removed, although fatalities can occur. Heightened awarness by clinicians is needed for prevention, early recognition and prompt treatment.
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