fluvoxamine and Syndrome

We experienced the first death case of the serotonin syndrome in Japan caused by fluvoxamine and tandospirone. A 15-year-old man was transported to our hospital for shock, muscle hypertonia and hyperthermia after cardiopulmonary arrest. His serum concentrations of fluvoxamine and tandospirone were 3,554 ng/mL and 698 ng/mL respectively after 24 hours from oral intake. He was dead in spite of intensive treatments. The progress of the serotonin syndrome is usually rapid. So, it should be monitored appropriately a patient with serotonin syndrome. If he has hyperthermia, immediate paralysis should be induced. We should aware of the serotonin syndrome a case of overdose on a serotonergic agent.

Topics: Adolescent; Anti-Anxiety Agents; Drug Overdose; Fatal Outcome; Fever; Fluvoxamine; Heart Arrest; Humans; Isoindoles; Japan; Male; Muscle Hypertonia; Piperazines; Pyrimidines; Selective Serotonin Reuptake Inhibitors; Serotonin Receptor Agonists; Severity of Illness Index; Shock; Syndrome

Topics: Aged; Antidepressive Agents, Second-Generation; Diagnosis, Differential; Drug Eruptions; Female; Fluvoxamine; Humans; Intertrigo; Peripheral Nervous System Diseases; Syndrome

Kleptomania is currently classified in psychiatric nomenclature as one of the impulse control disorders (DSM-IV, 1994). It is characterized by repeated failure to resist impulses to steal objects, not for personal use or monetary gain. The objects are therefore discarded, given away, or hoarded (ICD-10, 1992). This disorder is known since the early 18th century from the phenomenological and clinical viewpoints, yet is still debated with regard to therapeutic strategies and criminal liability. Although there are usually complications associated with the legal consequences of being caught and arrested, subjects continue to violate the law despite repeated arrests and convictions. In a 28-year old man suffering from kleptomania, years of psychodynamic psychotherapy were ineffective. Only when he was treated as suffering from an impulse control disorder or a variant of obsessive-compulsive disorder, was there significant improvement. The positive response to buspirone (5-HT1A) augmentation of fluvoxamine (SSRI) suggested that disturbed central serotonergic neurotransmission might play an important role in the pathogenesis of kleptomania. This concept is strengthened by the comorbidity of the syndrome with depression and by its compulsive traits. We stress that although kleptomaniacs cannot differentiate between right and wrong, testing shows that their sense of reality is intact, but they act under the influence of drives they cannot resist.

Topics: Adult; Buspirone; Disruptive, Impulse Control, and Conduct Disorders; Fluvoxamine; Humans; Male; Obsessive-Compulsive Disorder; Psychotherapy; Syndrome; Theft

To report a serotonin syndrome reaction in a patient taking fluvoxamine to replace an earlier SSRI agent.. A female patient with Obsessive Compulsive Disorder on paroxetine after resurgence in her obsessive ruminations was started on fluvoxamine 50 mg daily. One week later she became suicidal and was hospitalized. The fluvoxamine was increased to 50 mg morning and 100 mg bedtime and the paroxetine was discontinued. Over the next few days she began to have trouble with her concentration. A low grade fever set in after she experienced auditory hallucinations. Fluvoxamine was discontinued and she had an uneventful recovery after twenty-four hours.. Fluvoxamine is a recently approved serotonin selective reuptake inhibitor (SSRI) with few side effect profiles. It is effective in the treatment of Depressive Disorder and Obsessive Compulsive Disorder and is used to potentiate or replace other anti-OCD drugs including already available serotonin specific reuptake inhibitors (SSRI). We wish to draw attention to the potential for serotonin syndrome in patients on fluvoxamine who may have previously been on other SSRIs.

Topics: Adult; Antidepressive Agents, Second-Generation; Drug Therapy, Combination; Female; Fluvoxamine; Humans; Obsessive-Compulsive Disorder; Paroxetine; Psychoses, Substance-Induced; Selective Serotonin Reuptake Inhibitors; Syndrome; Time Factors

Topics: Adult; Akathisia, Drug-Induced; Antidepressive Agents; Clomipramine; Delirium; Diagnosis, Differential; Female; Fluvoxamine; Humans; Male; Middle Aged; Neuroleptic Malignant Syndrome; Serotonin; Syndrome

Topics: Buspirone; Drug Therapy, Combination; Fluvoxamine; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder; Psychoses, Substance-Induced; Receptors, Serotonin; Serotonin Antagonists; Serotonin Receptor Agonists; Syndrome

Topics: Bipolar Disorder; Drug Interactions; Female; Fluvoxamine; Humans; Lithium; Middle Aged; Neuromuscular Diseases; Serotonin; Syndrome

We evaluated patients abruptly withdrawn from fluvoxamine, a serotonin selective reuptake inhibitor, for evidence of a discontinuation syndrome.. In an open-label study, 14 subjects were abruptly withdrawn from fluvoxamine after treatment lasting 8 months (7 months for 1 patient). Psychological, somatic, and perceptual symptoms were assessed at Day 5, Day 10, and Day 14 postdiscontinuation. Anxiety and depression were assessed using clinician and self-rated scales.. Twelve (86%) of 14 subjects developed new symptoms. The most frequent symptoms reported were dizziness/incoordination, headaches, nausea, and irritability. Symptoms peaked on Day 5 postdiscontinuation. Only 1 subject had a recurrence of panic, but another developed anxiety and depression; both were remedicated.. Abrupt fluvoxamine discontinuation is associated with a characteristic syndrome in many patients.

Topics: Adult; Anxiety Disorders; Depressive Disorder; Dizziness; Female; Fluvoxamine; Follow-Up Studies; Humans; Male; Panic Disorder; Psychiatric Status Rating Scales; Recurrence; Severity of Illness Index; Substance Withdrawal Syndrome; Syndrome