Serotonin Syndrome in the Setting of Lamotrigine, Aripiprazole, and Cocaine Use.

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Kotwal A, Cutrona SL

Serotonin Syndrome in the Setting of Lamotrigine, Aripiprazole, and Cocaine Use.

Case Rep Med. 2015;2015:769531. doi: 10.1155/2015/769531. Epub 2015 Aug 2.

PubMed ID

26339247 [ View in PubMed

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Abstract

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. It is classically associated with the simultaneous administration of two serotonergic agents, but it can occur after initiation of a single serotonergic drug or increasing the dose of a serotonergic drug in individuals who are particularly sensitive to serotonin. We describe a case of serotonin syndrome that occurred after ingestion of higher than prescribed doses of lamotrigine and aripiprazole, in addition to cocaine abuse. The diagnosis was established based on Hunter toxicity criteria and severity was classified as mild. The features of this syndrome resolved shortly after discontinuation of the offending agents. Serotonin syndrome is characterized by mental status changes, autonomic hyperactivity, and neuromuscular abnormalities along a spectrum ranging from mild to severe. Serotonin syndrome in our patient was most likely caused by the pharmacokinetic and pharmacodynamic interactions between lamotrigine, aripiprazole, and cocaine leading to increased CNS serotonergic activity.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Lamotrigine	5-hydroxytryptamine receptor 3A	Protein	Humans	Unknown	Inhibitor	Details

Drug Interactions

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drugs	Interaction
Integrate drug-drug interactions in your software
Isocarboxazid Aripiprazole lauroxil	The risk or severity of serotonin syndrome can be increased when Aripiprazole lauroxil is combined with Isocarboxazid.
Minaprine Aripiprazole lauroxil	The risk or severity of serotonin syndrome can be increased when Aripiprazole lauroxil is combined with Minaprine.
Moclobemide Aripiprazole lauroxil	The risk or severity of serotonin syndrome can be increased when Aripiprazole lauroxil is combined with Moclobemide.
Nialamide Aripiprazole lauroxil	The risk or severity of serotonin syndrome can be increased when Aripiprazole lauroxil is combined with Nialamide.
Procaine Aripiprazole lauroxil	The risk or severity of serotonin syndrome can be increased when Aripiprazole lauroxil is combined with Procaine.