Serotonin syndrome associated with polypharmacy in the elderly.

Brian D Poeschla, Pauline Bartle, Karen P Hansen

Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104-2499, USA. bpoeschl@u.washington.edu

General hospital psychiatry 2011 May-Jun

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The increasing use of serotonergic agents, alone and in combination, across multiple disciplines, makes it likely that the prevalence of serotonin syndrome will rise. Caution should be used, especially in the elderly, to avoid unnecessary and potentially harmful polypharmacy. We describe a case of serotonin syndrome in a 79-year-old man taking mirtazapine, venlafaxine and quetiapine. As this case illustrates, serotonin syndrome can be caused by combinations of direct serotonin agonists (e.g., serotonergic antidepressants) and indirect serotonin agonists (e.g., atypical antipsychotics). Copyright © 2011 Elsevier Inc. All rights reserved.

Citation

Brian D Poeschla, Pauline Bartle, Karen P Hansen. Serotonin syndrome associated with polypharmacy in the elderly. General hospital psychiatry. 2011 May-Jun;33(3):301.e9-11