Document Detail

Serotonin syndrome induced by fluvoxamine and oxycodone.
MedLine Citation:
PMID:  16368927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report a case of severe serotonergic symptoms following the addition of oxycodone to fluvoxamine. CASE SUMMARY: A 70-year-old woman developed severe serotonergic features, including confusion, nausea, fever, clonus, hyperreflexia, hypertonia, shivering, and tachycardia, following the addition of oxycodone 40 mg twice daily to fluvoxamine 200 mg/day, easily fulfilling diagnostic criteria for serotonin syndrome. Discontinuation of the offending drugs resulted in resolution of her symptoms over 48 hours, and no other cause of the syndrome was identified. Use of the Naranjo probability scale indicated a probable relationship between the serotonergic symptoms and the addition of oxycodone to fluvoxamine therapy. DISCUSSION: Serotonin syndrome is a serious adverse reaction usually due to interactions with serotonergic drugs. There have been only 3 previous reports involving oxycodone. Most previous reports of serotonin syndrome involving analgesics have been associated with meperidine, dextromethorphan, and tramadol. Unlike these synthetic opioids, however, oxycodone does not inhibit the reuptake of serotonin. In addition, there are a number of other possible pharmacologic mechanisms for the interaction we observed. CONCLUSIONS: Monitoring for serotonergic adverse events should be done when oxycodone is given to patients receiving serotonin-reuptake inhibitors.
Harindra Karunatilake; Nicholas A Buckley
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2005-12-20
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  40     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-06     Completed Date:  2006-04-10     Revised Date:  2006-10-13    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-7     Citation Subset:  IM    
The Canberra Hospital, Canberra, New South Wales, Australia.
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MeSH Terms
Analgesics, Opioid / adverse effects,  therapeutic use
Depression / drug therapy
Drug Interactions
Fluvoxamine / adverse effects*,  therapeutic use
Oxycodone / adverse effects*,  therapeutic use
Pain / drug therapy
Serotonin Syndrome / chemically induced*,  physiopathology
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
Reg. No./Substance:
0/Analgesics, Opioid; 0/Serotonin Uptake Inhibitors; 54739-18-3/Fluvoxamine; 76-42-6/Oxycodone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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