[Combination of serotonergic agents resulted in severe adverse effects].

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Jagestedt M, von Bahr C

[Combination of serotonergic agents resulted in severe adverse effects].

Lakartidningen. 2004 Apr 29;101(18):1618-9.

PubMed ID

15185539 [ View in PubMed

]

Abstract

A 52 year old woman on buspirone was prescribed paroxetine for depressive symptoms. She also got papaverine. Within a month she experienced high fever, shivering, tremor, hyper-reflexia, tachycardia (120 bpm), and tracheal cramps, symptoms of the serotonin syndrome. Since both paroxetine and buspirone have serotonergic effects it is probable that the symptoms were caused by the drug combination. She also had ecchymoses on her thighs, probably due to serotonergic effects. The symptoms rapidly decreased after withdrawing paroxetine. Paroxetine, papaverine, and possibly also buspirone interact with cytochrome P450 CYP2D6. They can probably inhibit the metabolism of each other. We recommend observance of serotonergic syndrome symptoms and restricted combination of serotoninergic drugs.

DrugBank Data that Cites this Article

Drug Enzymes

Drug	Enzyme	Kind	Organism	Pharmacological Action	Actions
Buspirone	Cytochrome P450 2D6	Protein	Humans	Unknown	Substrate	Details