Carrillo ER, Carrillo CLD, Carrillo CJR, Uribe RM, González ÁD

Idioma: Español
Referencias bibliográficas: 36
Paginas: 93-98
Archivo PDF: 95.81 Kb.

RESUMEN

Introducción: El síndrome serotoninérgico se presenta cuando los niveles de serotonina se incrementan en el sistema nervioso central. Es secundario al efecto farmacológico de los inhibidores selectivos de la recaptura de serotonina, opioides, algunos antibióticos, y medicamentos con actividad serotoninérgica en interacción farmacológica que resulta en modulación de la función del sistema serotoninérgico. El síndrome se caracteriza por la tríada de alteraciones en el estado mental, alteraciones neuromusculares y disfunción autonómica.
Caso clínico: Se presenta un caso de síndrome serotoninérgico secundario a la interacción de linezolid, tramadol y olanzapina. El paciente presentó evolución satisfactoria con la combinación de ciproheptadina y medidas de apoyo.
Conclusiones: Se revisa la fisiopatología, diagnóstico, diagnóstico diferencial y tratamiento del síndrome serotoninérgico. Enfatizamos sobre el riesgo de su elevada prevalencia en la Unidad de Terapia Intensiva.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Birmes P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. Can Med Assoc J 2003;168: 1439-1442.

2. Muñoz CH, Vargas RA. Síndrome serotoninérgico. MedUNAB 2004;7:144-150.

3. Insel TR, Roy BF, Cohen RM, Murophy DL. Possible development of the serotonin syndrome in man. Am J Psychiatry 1982;139:954-955.

4. Sternbach H. The serotonin syndrome. Am J Psychiatry 1991;148:705-713.

5. Sampson E, Warner JP. Serotonin syndrome: potentially fatal but difficult to recognize. Br J Gen Pract 1999;49: 867-868.

6. Isbister GK, Bowe SJ, Dawson A, Whyte IM. Relative toxicity of selective serotonin reuptake inhibitors in overdose. J Toxicol Clin Toxicol 2004;42:277-285.

7. Watson WA, Litovitz TL, Rodgers GC Jr. 2002 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2003;21:353-421.

8. Gill M, LoVecchio F, Selden B. Serotonin syndrome in a child after a single dose of fluvoxamine. Ann Emerg Med 1999;33:457-459.

9. Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry 2003;60:720-726.

10. Boyer EW, Shanon M. The serotonin syndrome. N Engl J Med 2005;352:1112-1120.

11. Hoyer D, Clarke DE, Fozard JR. International Union of Pharmacology classification of receptors for 5-hydroxytryptamine (serotonin). Pharmacol Rev 1994;46:157-203.

12. Mills K. Serotonin syndrome. Crit Care Clin 1998;13:763-783.

13. Graeff F. Serotonin systems. Psych Clin North Am 1997;20:723-739.

14. Nisijima K, Shioda K, Yoshino T, Takano K, Kato S. Memantine, an NMDA antagonist, prevents the development of hyperthermia in an animal model for serotonin syndrome. Pharmacopsychiatry 2004;37:57-62.

15. Lawrence KR, Adra M, Gillman PK. Serotonin toxicity associated with the use of linezolid: A review of postmarketing data. Clin Infect Dis 2006;42:1578-1583.

16. Thomas CR, Rosenberg M, Blythe V, Meyer WJ. Serotonin syndrome and linezolid. J Am Acad Child Adolesc Psychiatry 2004;43:790-792.

17. Wigen CL, Goetz MB. Serotonin syndrome and linezolid. Clin Infect Dis 2002;34:1651-1652.

18. Gill M, LoVecchio F, Selden B. Serotonin syndrome in a child after a single dose of fluvoxamine. Ann Emerg Med 1999;33:457-459.

19. Mitchell PB. Interactions of clinical significance with selective serotonin reuptake inhibitors. Drug Saf 1997;17: 390-406.

20. Gillman PK. Ectasy, serotonin syndrome and the treatment of hyperpyrexia. Med J Aust 1997;167:109-111.

21. Demirkiran M, Jankivic J, Dean JM. Ectasy intoxication: an overlap between serotonin syndrome and neuroleptic malignant syndrome. Clin Neuropharmacol 1996;19: 157-164.

22. Mahlber R, Kunz D, Sarse J, Kircheiner J. Serotonin syndrome with tramadol plus citalopram. Am J Psych 2004;161:1129-1132.

23. Houilihan DJ. Serotonin syndrome from coadministration of tramadol, venlafaxine and mirtazapine. Ann Pharmacother 2004;38:411-413.

24. Lange-Asschenfeldt C, Weigmann H, Hiemke C, Mann K. Serotonin syndrome as a result of fluoxetine in a patient with tramadol abuse: plasma level correlated symptomatology. J Clin Psychopharmacol 2002;22:440-442.

25. Chapra P, Ng C, Schweitzer I. Serotonin syndrome with fluoxetine and olanzapine. World J Biol Psychiatry 2004;2:114-115.

26. Duggal HS, Fetchko J. Serotonin syndrome and atypical antipsychotic. Am J Psychiatry 2002;159:672-673.

27. Birnes P, Coopin D, Schmitt, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003;168:1439-1442.

28. Radomki JW, Dursun SM, Rvely MA, Kutcher SP. An exploratory approach to the serotonin syndrome: an update of clinical phenomenology and revised diagnostic criteria. Med Hypotheses 2000;55:218-224.

29. Whyte I, Dawson A. Redefining the serotonin syndrome. J Toxicol Clin Toxicol 2002;40:668-669.

30. Kaneda Y, Ohmori T, Fujii A. The serotonin syndrome: investigation using the Japanese version of the serotonin syndrome scale. Psychiatry Res 2001;105:135-142.

31. Graundis A, Stearman A, Chan B. Treatment of the serotonin syndrome with cyproheptadine. J Emerg Medicine 1998;16:615-619.

32. Lappin RI, Auchincloss EL. Treatment of the serotonin syndrome with cyproheptadine. N Engl J Med 1994;331: 1021-1022.

33. Kapur S, Zipursky RB, Jones C, Wilson AA, DaSilva JD, Houle S. Cyproheptadine: a potent in vivo serotonin antagonist. Am J Psychiatry 1997;154:884-886.

34. Gillman PK. The serotonin syndrome and its treatment. J Psychopharmacol 1999;13:100-109.

35. Brown TM, Skop BP, Mareth TR. Pathophysiology and management of the serotonin syndrome. Ann Pharmacother 1996;30:527-533.

36. Gandhy AP, Varney AJ, Resch DS. Serotonin syndrome. J Gen Inter Med 2002;17:40-41.