Citation

Milovac Z, Pisk SV, Silić A, Mihanović M. Socijalna Psihijatrija 2010; 38(1): 80-84.

Copyright

(Copyright © 2010, Clinic for Psychiatry, University Hospital Centre Zagreb and School of Medicine)

DOI

unavailable

PMID

unavailable

Abstract

Serotonin syndrome is an iatrogenic disorder that was first reported in the 1950s. It is characterized by neuromuscular symptoms, alteration in mental status and derangement of autonomic function, taking into consideration that these symptoms do not evolve from psychiatric disorder. Approximately 85 percent of clinicians are unaware of the serotonin syndrome as a clinical diagnosis. We present a female patient suspected of serotonin syndrome on her first and fourth hospitalization. Her first hospitalization was in 2004, after a suicidal attempt with antidepressant drugs. Before her fourth admission to the hospital in 2008, she took amitriptyline in high yet unknown doses. The patient was taken to the emergency room in the presence of police upon her neighbors' report to the police. She was disoriented in time, anxious, tense, agitated and fearful, with incoherent speech, tremor and hyperreflexia. Both serotonin syndrome and medication induced delirium were taken into consideration. During three hospitalizations she was treated for depression, however, on her fourth hospitalization the diagnosis was revised to bipolar affective disorder. This case report is presented to show how the serotonin syndrome symptoms interfere with the signs and symptoms of other psychiatric disorders, thus being difficult to make an accurate diagnosis without thorough history/heterohistory data and patient observation.

Language: sr

Keywords

human; female; case report; bipolar disorder; depression; anxiety; suicide attempt; Antidepressants; hospitalization; article; antidepressant agent; amitriptyline; fear; tremor; delirium; disorientation; serotonin syndrome; agitation; diagnostic value; hyperreflexia; Delirium; Serotonin syndrome; speech disorder