A Rare Overlap of Serotonin Syndrome and Status Epilepticus Confirmed on Electroencephalogram

Serotonin syndrome (SS) is a potentially fatal complication of treatment with various serotonergic agents. It is diagnosed clinically and consists of cognitive, autonomic, and neuromuscular dysfunction. Although serotonin syndrome has been known to induce seizures, there are no reported cases of electroencephalogram (EEG)-documented status epilepticus (SE) associated with serotonin syndrome. We report a case of serotonin syndrome and status epilepticus in a patient thought to have overdosed on both fluoxetine and bupropion in the setting of alcohol intoxication. Our patient required aggressive treatment with various anticonvulsant medications to control status epilepticus and was also treated with cyproheptadine for the serotonin syndrome. This paper will also discuss the contributing factors of fluoxetine and bupropion to this presentation in the context of alcohol intoxication.