Fukushima J. Med. Sci.,
Vol. 52, No. 1, 2006

[Case Report]

SEROTONIN SYNDROME CAUSED BY MINIMUM DOSES OF
SSRIS IN A PATIENT WITH SPINAL CORD INJURY

KOICHIRO SATOH¹⁾, SHIZUKO TAKANO²⁾, TAKASHI ONOGI¹⁾,
KOJI OHTSUKI¹⁾ and TOSHIO KOBAYASHI¹⁾

¹⁾Institute of Physical Medicine and Rehabilitation, Fukushima Medical University School of
Medicine, Fukushima, 960-0201, Japan
²⁾Department of Pharmacology, Fukushima Medical University School of Medicine,
Fukushima, 960-1295, Japan

(Received March 7, 2006, accepted April 17, 2006)

Abstract: 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°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.

Key words: Fluvoxamine, Paroxetine, Serotonin syndrome, Spinal cord injury

擺藤抂一郎戮揩野敕子戮擣野木搜戮大槻揆智戮擣林利男

Correspondence to: Koichiro Satoh, Institute of Physical Medicine and Rehabilitation, Fukushima City 960-0201, Japan.
E-mail: kouichi@fmu.ac.jp