A Case of Serotonin Syndrome: Toxicity and Management of Overdose of Escitalopram - Case Report and Review of Literature

Abstract

The serotonin syndrome is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, intentional self-poisoning, or inadvertent interactions between drugs. It is identified through a particular dose-relevant spectrum of the clinical finding, that related to the serotonin free level (5-hydroxytryptamine [5-HT]), or the activation of 5-Ht receptor (predominantly 5-HT2A subtypes and the 5-HT1A), that further involves changes of mental state, autonomic hyperactivity and neuromuscular abnormalities. Critical serotonin syndrome is barely and in generally precipitated through the frequent initiation of multiple serotonergic drugs. Yet this specific syndrome could further arise afterwards single serotonergic drug initiations in the susceptible individual, the overall addition of third or second agents towards the long-standing doses of serotonergic drug maintenance or else afterwards an overdose. 

Here we present a case of Escitalopram induced serotonin syndrome. A 24 year old female, in postpartum period, had alleged consumed multiple tablets of Escitalopram. The patient was admitted to ICU and treated. Patient improved over a period of 48 hours and was later discharged.

Here we present a case of Escitalopram induced serotonin syndrome. A 24 year old female, in postpartum period, had alleged consumed 4500 mg of Escitalopram. She was brought to emergency department of the hospital in a semi-conscious state. All the necessary measures were taken as per poisoning protocol, stomach wash given and the patient was later admitted to ICU and managed. Patient improved over a period of 48 hours and was later shifted to ward. A Psychiatrist opinion was taken and was diagnosed to be having post-partum depression. The patient was later discharged with follow-up medications.