Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient

Authors

  • Rajnish Raj Department of Psychiatry Government Medical College and Rajindra Hospital, Patiala- 147001, Punjab, India
  • Raj Kumar Department of Pharmacology, Guru Gobind Singh Medical College, Baba Farid University of Health Sciences, Faridkot- 151203, Punjab, India
  • Balwant Singh Sidhu Department of Psychiatry Government Medical College and Rajindra Hospital, Patiala- 147001, Punjab, India
  • Saurabh Yakhami Department of Psychiatry Government Medical College and Rajindra Hospital, Patiala- 147001, Punjab, India

Keywords:

Serotonin syndrome, SSRIs (Serotonin Reuptake Inhibitors), Opioids, Drug-drug interactions, CYP 450

Abstract

Serotonin syndrome causes confusion or altered mental status; other symptoms include myoclonus, shivering, tremors, diaphoresis, hyperreflexia, incoordination, fever and diarrhoea. Tramadol possesses dual pharmacological effects i.e., a weak opiate agonist at mu, kappa and delta opiate receptors along with reuptake inhibition of norepinephrine and serotonin. Risk associated with tramadol increases when co-administered with serotonergic antidepressants or MAOIs (monoamine oxidase inhibitors) and in renal impaired. The incidence of this syndrome is less than 1% as most of the cases remain unreported. The case highlights the fact that interaction between serotonergic agents like fluoxetine and tramadol especially in the presence of co-morbid medical illness can lead to serotonin syndrome.

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Published

2017-01-23

How to Cite

Raj, R., Kumar, R., Sidhu, B. S., & Yakhami, S. (2017). Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient. International Journal of Basic & Clinical Pharmacology, 3(1), 227–229. Retrieved from https://www.ijbcp.com/index.php/ijbcp/article/view/984