Combination Risperidone and SSRI–Induced Serotonin Syndrome

@article{Karki2003CombinationRA,  title={Combination Risperidone and SSRI–Induced Serotonin Syndrome},  author={Shyam D. Karki and Gule-Rana Masood},  journal={Annals of Pharmacotherapy},  year={2003},  volume={37},  pages={388 - 391},  url={https://api.semanticscholar.org/CorpusID:36677580}}
Clinicians treating elderly patients with combined risperidone and SSRIs to include serotonin syndrome in differential diagnosis if the patient is showing signs of increasing agitation with escalating doses of ris peridone.

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43 Citations

Serotonin Syndrome in Elderly Patients Treated for Psychotic Depression with Atypical Antipsychotics and Antidepressants: Two Case Reports

Two cases of serotonin syndrome in elderly patients during treatment of psychotic depression with atypical antipsychotics and antidepressants are reported, and it is believed that serotonin syndrome was produced by a combination of an antidepressant and an atypicals antipsychotic.

Coexistence of serotonin syndrome and neuroleptic malignant syndrome: does it exist?

A 21-year-old man with bipolar disorder who was on a stable dose of escitalopram and risperidone was reported, and cyproheptadine was started, and the presence of both SS and neuroleptic malignant syndrome was considered in this case.

Atypical neuroleptic malignant syndrome or serotonin toxicity associated with atypical antipsychotics?

The author addressed himself to the issues surrounding the neurotoxic reaction to the treatment regimen containing atypical antipsychotics, focusing on the "atypical" forms of NMS and pathophysiological as well as clinical features of serotonin toxicity.

Generalized Myoclonus in an Elderly Patient on Risperidone: A Rare but Important Adverse Effect

A patient who developed generalized myoclonic jerks while on long-term risperidone therapy, in the context of concomitant sertraline use, without fulfilling clinical criteria for serotonin syndrome is described.

Extrapyramidal Symptoms Probably Related to Risperidone Treatment: A Case Series

A strong temporal correlation between risperidone and EPS was noted in all cases and cautious use and close monitoring are warranted in the chronic use of ris peridone.

A 70-Year-Old Woman Presenting with Confusion and Muscle Spasms Due to Serotonin Syndrome Associated with Paroxetine and Quetiapine Treatment

Dealing with serotonin toxicity requires a high degree of clinical suspicion and can occur in the absence of increased dosage of existing, or initiation of new, serotonergic agents.

Acute nocturnal akathisia induced by clozapine.

Akathisia, a subjective complaint of restlessness accompanied by observed movements of the legs, is one of the most disagreeable extrapyramidal side effects of medications and often causes noncompliance in patients with schizophrenia.

19 References

Severe Serotonin Syndrome Induced by Mirtazapine Monotherapy

Bearing SS in mind when prescribing this drug is suggested, especially in frail, elderly patients with underlying chronic conditions, and it might be more adequate to start mirtazapine therapy at a lower dose (<15 mg/d).

Serotonin Syndrome Presentation of 2 Cases and Review of the Literature

It was found that patients with serotonin syndrome most often presented within 24 hours of medication initiation, overdose, or change in dosage, and most patients had complete resolution of their symptoms within 24Hours of presentation.

Antidepressants and the serotonin syndrome in general practice.

Improved awareness of the serotonin syndrome is needed within general practice, and there is a need to distinguish the relatively minor serotonergic symptoms from those of a severe, life-threatening serotonin syndrome.

The Serotonin Syndrome

Because fatalities and severe complications have accompanied the serotonin syndrome, the previously described drug combinations should be used cautiously or not at all.

Selective serotonin reuptake inhibitor-induced serotonin syndrome: review.

To reduce the occurrence, morbidity, and mortality of the serotonin syndrome, it must be both prevented by prudent pharmacotherapy and given prompt recognition when it is present.

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The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment, and further work is needed to establish the diagnostic criteria, incidence, and predisposing factors.

Plasma Concentrations of Risperidone and 9-Hydroxyrisperidone During Combined Treatment With Paroxetine

The authors' findings indicate that paroxetine, a potent inhibitor of CYP2D6, may impair the elimination of risperidone, primarily by inhibiting CYP 2D6-mediated 9-hydroxylation and to a lesser extent by simultaneously affecting the further metabolism of 9-OH-riseridone or other pathways of ris peridone biotransformation.

Serotonin syndrome: history and risk

It is proposed that more systematic national collection of toxicity data is essential in order to quantify the relative risk of serotonin syndrome with various combinations of serotonergic drugs.

Serotonin syndrome resulting from drug interactions

Six patients diagnosed with serotonin syndrome after exposure to drugs with serotonergic activity were diagnosed and management included supportive care and the use of non‐specific serotonin antagonists.

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