Delayed onset serotonin syndrome in the setting of polypharmacy

Roshan Acharya; Smita Kafle; Sijan Basnet; DilliRam Poudel; Sushil Ghimire

doi:10.1080/20009666.2020.1834929

Delayed onset serotonin syndrome in the setting of polypharmacy

J Community Hosp Intern Med Perspect. 2021 Jan 26;11(1):76-78. doi: 10.1080/20009666.2020.1834929.

Authors

Roshan Acharya¹, Smita Kafle², Sijan Basnet³, DilliRam Poudel⁴, Sushil Ghimire⁵

Affiliations

¹ Department of Medicine, Cape Fear Valley Hospital, Fayetteville, NC, USA.
² Fayetteville State University, Fayetteville, NC, USA.
³ Department of Medicine, Reading Hospital, Reading, PA, USA.
⁴ Department of Rheumatology, Indiana Regional Medical Center, Indiana, PA, USA.
⁵ Department of Hematology and Oncology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Abstract

Serotonin syndrome is a rare but well-known condition that can be life-threatening if not diagnosed early. Onset is usually within 4 to 13 h of starting the offending medication. We present a case of delayed onset of serotonin syndrome that presented after 48 h. Polypharmacy played a role in causing the onset of symptoms. Clinicians should keep a high index of suspicion for serotonin syndrome when dealing with elderly confused patients who take multiple medications even when the onset is delayed or atypical because the outcome can be disastrous.

Keywords: Serotonin; polypharmacy.

Publication types

Case Reports