Lithium and venlafaxine interaction: A case of serotonin syndrome
Universidad Autónoma de Madrid, Madrid, Madrid, SpainJournal of Clinical Pharmacy and Therapeutics (Impact Factor: 1.67). 07/2006; 31(4):397 - 400. DOI: 10.1111/j.1365-2710.2006.00745.x
Serotonin syndrome, which occurs as a result of enhanced serotonin concentration in the central nervous system, is a well-known adverse effect of serotonin-active medications. The concomitant use of antidepressant drugs associated with lithium as a co-adjuvant seems to increase the risk of this adverse reaction. We report a case of the serotonin syndrome during treatment with lithium and venlafaxine, an antidepressant with a dual selective re-uptake inhibition mechanism, and review the literature for similar cases. A 71-year-old woman developed serotonin syndrome while receiving treatment with moderate doses of lithium and venlafaxine for refractory depression. She had been taking higher doses of venlafaxine during the previous months with no significant secondary effects. Use of the Naranjo adverse drug reaction probability algorithm indicated a probable relationship between serotonin syndrome and treatment with lithium and venlafaxine.
Article: Serotonin syndrome[Show abstract] [Hide abstract]
ABSTRACT: The serotonin syndrome is characterized by features of neuromuscular hyperactivity, autonomic instability, and alteration of mental status. It is the clinical manifestation of serotonin toxicity resulting from the combination of drugs that cause increased intra-synaptic serotonin activity. Antidepressant drugs and drugs of abuse are well-recognized causes. The syndrome can also be triggered by a variety of other drugs with serotonergic effects, including opioids, appetite-suppressant drugs, herbal products and drugs used for anxiety, migraine, and Parkinson's disease.Adverse Drug Reaction Bulletin 04/2007; 243(243):931-4.
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