INTRODUCCIÓN:
El
síndrome serotoninérgico es un cuadro clínico debido a altos niveles de
serotonina. Está causado por el uso de uno o varios
fármacos con actividad serotoninérgica de forma concomitante. Su
diagnóstico es clínico y se lleva a cabo según criterios diagnósticos. CASO CLÍNICO
Paciente de 65años en
seguimiento de larga evolución por trastorno afectivo bipolar con reciente instauración de
tratamiento con
amitriptilina. En
urgencias se observa
temblor distal,
ataxia, bradipsiquia, desorientación temporoespacial, discinesia orolingual, miocolonías oculares y diaforesis. Se descartan posibles etiologías causantes del cuadro.
RESULTADOS:
Apareció un
síndrome serotoninérgico tras la instauración de
amitriptilina. No fueron necesarias
medidas invasivas de soporte. Se retiró el
tratamiento con psicofármacos y se instauraron progresivamente aquellos sin actividad serotoninérgica.
CONCLUSIONES:
No es necesario el uso concomitante de varios
fármacos serotoninérgicos, sino que puede aparecer este
síndrome con el uso de un fármaco instaurado de forma brusca
INTRODUCTION:
Serotoninergic
syndrome is a clinical disorder due to high levels of
serotonin. It is caused by the concomitant use of one or several
drugs with high serotoninergic activity. Its
diagnosis is clinical, and is made following some diagnostic criteria. CLINICAL CASE The case concerns a 65 year-old
patient on long-term follow due to a bipolar
affective disorder, and
who recently started
treatment with
amitriptyline. In the
Emergency Department, distal
tremor was observed, as well as
ataxia, bradypsychia,
time-space
orientation, orolingual
dyskinesia, ocular
myoclonus, and diaphoresis. Possible aetiological causes of the
syndrome were ruled.
RESULTS:
A serotoninergic
syndrome appeared after starting
amitriptyline treatment. Invasive support
measures were not necessary. The
treatment with psychiatric
drugs was withdrawn and gradually started with those without serotoninergic activity.
CONCLUSIONS:
The concomitant use of several serotoninergic
drugs is not necessary, although this
syndrome can appear with the use of a suddenly introduced
drug