Document Detail


Serotonin syndrome triggered by a single dose of suboxone.
MedLine Citation:
PMID:  18774063     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Suboxone (buprenorphine/naloxone) is an oral medication used for the treatment of opiate dependence. Because of its mixed properties at the opiate receptors, buprenorphine has a ceiling on its euphoric effects. We report the first case of serotonin syndrome caused by buprenorphine and review other medications implicated in serotonin syndrome. A 54-year-old man on tricyclic antidepressants took an unprescribed dose of buprenorphine/naloxone. He presented to the emergency department with signs and symptoms of severe serotonin syndrome including clonus, agitation, and altered mental status. His agitation was not controlled with benzodiazepines and was electively intubated. At the recommendation of the toxicology service, cyproheptadine, a serotonin receptor antagonist, was administered with improvement in the patient's symptoms. Emergency physicians should be aware of the potential of buprenorphine/naloxone to trigger serotonin syndrome.
Authors:
Derek Isenberg; Stella C Wong; John A Curtis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  26     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  840.e3-5     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA 19102, USA. disenber@drexelmed.edu
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MeSH Terms
Descriptor/Qualifier:
Buprenorphine / adverse effects*
Cyproheptadine / therapeutic use
Humans
Male
Middle Aged
Naloxone / adverse effects*
Narcotic Antagonists / adverse effects*
Serotonin Antagonists / therapeutic use
Serotonin Syndrome / chemically induced*,  drug therapy,  physiopathology*
Chemical
Reg. No./Substance:
0/Narcotic Antagonists; 0/Serotonin Antagonists; 0/suboxone; 129-03-3/Cyproheptadine; 465-65-6/Naloxone; 52485-79-7/Buprenorphine

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


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