lisdexamfetamine-dimesylate and Serotonin-Syndrome

Topics: Adolescent; Dopamine Uptake Inhibitors; Dyskinesias; Fluoxetine; Humans; Lisdexamfetamine Dimesylate; Male; Psychomotor Agitation; Selective Serotonin Reuptake Inhibitors; Serotonin Syndrome

A 5-month-old intact female domestic shorthaired cat had mydriasis, agitation, and increased locomotion after ingestion of lisdexamfetamine, 10.3 mg/kg body weight (BW). Despite treatment with IV fluids, IV acepromazine, oral cyproheptadine and intravenous lipid emulsion the patient's clinical signs worsened. Dexmedetomidine administered at 2 μg/kg BW and continued at 0.5 μg/kg BW per hour rapidly controlled the patient's signs. An episode of vomiting and hematuria developed. Follow-up 5 days after discharge revealed that the cat appeared normal.

Topics: Adrenergic alpha-2 Receptor Agonists; Animals; Cat Diseases; Cats; Dexmedetomidine; Female; Lisdexamfetamine Dimesylate; Serotonin Syndrome

A 6-year-old girl displayed symptoms of serotonin syndrome after accidental ingestion of Vyvanse (lisdexamfetamine dimesylate). Dexmedetomidine was administered because of persistent neuromuscular hyperactivity and severe agitation despite initial therapy with benzodiazepines. Some children show a paradoxical reaction to benzodiazepines, and dexmedetomidine has a possible role in the treatment of serotonin syndrome.

Topics: Adrenergic alpha-2 Receptor Agonists; Anti-Anxiety Agents; Central Nervous System Stimulants; Child; Dexmedetomidine; Dextroamphetamine; Drug Overdose; Female; Humans; Lisdexamfetamine Dimesylate; Lorazepam; Midazolam; Serotonin Syndrome