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Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report

Serotonin syndrome is a potentially life-threatening drug effect. It may be misdiagnosed because it has mostly been reported in adults. Case Report. An 8-year-old girl with behavioral problems and medicated with risperidone and sertraline was admitted in the emergency department after she had taken...

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Autores principales: Grenha, Joana, Garrido, Ana, Brito, Hernani, Oliveira, Maria José, Santos, Fátima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880707/
https://www.ncbi.nlm.nih.gov/pubmed/24455378
http://dx.doi.org/10.1155/2013/897902
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author Grenha, Joana
Garrido, Ana
Brito, Hernani
Oliveira, Maria José
Santos, Fátima
author_facet Grenha, Joana
Garrido, Ana
Brito, Hernani
Oliveira, Maria José
Santos, Fátima
author_sort Grenha, Joana
collection PubMed
description Serotonin syndrome is a potentially life-threatening drug effect. It may be misdiagnosed because it has mostly been reported in adults. Case Report. An 8-year-old girl with behavioral problems and medicated with risperidone and sertraline was admitted in the emergency department after she had taken voluntarily 1500 mg of sertraline (50 mg/kg). At admission, she had marked agitation, visual hallucinations, diaphoresis, flushing, and tremor. She had fever and periods of hypertension. She also showed generalized rigidity and involuntary movements. She was treated with fluids and iv diazepam, midazolam, clemastine, and biperiden. As the patient presented a severe insomnia and a progressive rhabdomyolysis, she was transferred to pediatric intensive care unit (ICU), where she was under treatment with cyproheptadine, mechanical ventilation, and muscular paralysis for 11 days. She was discharged from hospital a few days later with no neurological sequelae. Conclusions. Serotonin syndrome is still not well recognized by physicians. In our patient, the diagnosis was made early due to the history of overdose with serotonin reuptake inhibitors and the triad of mental, neurological, and autonomic signs. Parents must be educated to prevent children from having free access to drugs, avoiding self-medication or overdose.
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spelling pubmed-38807072014-01-20 Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report Grenha, Joana Garrido, Ana Brito, Hernani Oliveira, Maria José Santos, Fátima Case Rep Pediatr Case Report Serotonin syndrome is a potentially life-threatening drug effect. It may be misdiagnosed because it has mostly been reported in adults. Case Report. An 8-year-old girl with behavioral problems and medicated with risperidone and sertraline was admitted in the emergency department after she had taken voluntarily 1500 mg of sertraline (50 mg/kg). At admission, she had marked agitation, visual hallucinations, diaphoresis, flushing, and tremor. She had fever and periods of hypertension. She also showed generalized rigidity and involuntary movements. She was treated with fluids and iv diazepam, midazolam, clemastine, and biperiden. As the patient presented a severe insomnia and a progressive rhabdomyolysis, she was transferred to pediatric intensive care unit (ICU), where she was under treatment with cyproheptadine, mechanical ventilation, and muscular paralysis for 11 days. She was discharged from hospital a few days later with no neurological sequelae. Conclusions. Serotonin syndrome is still not well recognized by physicians. In our patient, the diagnosis was made early due to the history of overdose with serotonin reuptake inhibitors and the triad of mental, neurological, and autonomic signs. Parents must be educated to prevent children from having free access to drugs, avoiding self-medication or overdose. Hindawi Publishing Corporation 2013 2013-12-19 /pmc/articles/PMC3880707/ /pubmed/24455378 http://dx.doi.org/10.1155/2013/897902 Text en Copyright © 2013 Joana Grenha et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Grenha, Joana
Garrido, Ana
Brito, Hernani
Oliveira, Maria José
Santos, Fátima
Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title_full Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title_fullStr Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title_full_unstemmed Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title_short Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report
title_sort serotonin syndrome after sertraline overdose in a child: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880707/
https://www.ncbi.nlm.nih.gov/pubmed/24455378
http://dx.doi.org/10.1155/2013/897902
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