Open AccessSerotonin Syndrome with Tramadol and Dextromethorphan
Author(s) -
Kung SW,
Ng MH
Publication year - 2007
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490790701400109
Subject(s) - tramadol , serotonin syndrome , medicine , dextromethorphan , serotonin , anesthesia , pharmacology , fluoxetine , serotonergic , cyp2d6 , mdma , monoamine oxidase , analgesic , receptor , biochemistry , chemistry , cytochrome p450 , metabolism , enzyme
Serotonin syndrome is an iatrogenic drug‐induced synaptic serotonin concentration related toxidrome. A 29‐year‐old man developed agitation, tachycardia and myoclonus of limbs after an intramuscular injection of 100 mg tramadol. He had recently been given multiple medications, including dextromethorphan (DXM) by a private doctor for flu‐like symptoms. The patient was stabilised with diazepam, midazolam and supportive treatment. Both tramadol and DXM could cause the serotonin syndrome, but usually in combination with monoamine oxidase inhibitors or serotonin reuptake inhibitors. This was the first reported case in the English literature of serotonin syndrome with tramadol and DXM. Therefore, a detailed drug history and knowledge of potential serotonergic drugs are important.