Document Detail


The role of methylene blue in serotonin syndrome: a systematic review.
MedLine Citation:
PMID:  20484716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A recent series of case reports has demonstrated a significant, previously unrecognized drug interaction between serotonin reuptake inhibitors (SRIs) and methylene blue (MB).
OBJECTIVE: The authors review the case reports and clinical audits relevant to this interaction and consider the diagnosis of serotonin syndrome in these cases.
METHOD: Articles were obtained from a systematic search of MEDLINE and PsychInfo databases, and from the bibliographies of relevant articles. Studies were considered relevant if the patient received MB and developed an acute confusional state, neuropsychiatric complications, or autonomic instability.
RESULTS: The review identified nine case reports and two retrospective reviews; 26 patients developed an acute confusional state after MB infusion; 24 of these patients were taking an SRI, and 1 was taking clomipramine. Serotonin syndrome was a possible diagnosis in all 25 of these patients.
CONCLUSION: SRIs can interact with MB, causing a serious adverse reaction consistent with serotonin syndrome.
Authors:
Bradley K W Ng; Andrew J D Cameron
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Psychosomatics     Volume:  51     ISSN:  1545-7206     ISO Abbreviation:  Psychosomatics     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-09-30     Revised Date:  2012-04-24    
Medline Journal Info:
Nlm Unique ID:  0376506     Medline TA:  Psychosomatics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  194-200     Citation Subset:  IM    
Affiliation:
correspondence and Aged Care Mental Health, Robina Hospital, Gold Coast Health Service District, Locked Bag 15, Robina, QLD 4226, Australia. bkwng@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Antidepressive Agents, Tricyclic / administration & dosage,  toxicity
Clomipramine / administration & dosage,  toxicity
Drug Interactions
Female
Humans
Infusions, Intravenous
Male
Methylene Blue / administration & dosage,  diagnostic use,  toxicity*
Middle Aged
Postoperative Complications / chemically induced,  diagnosis
Serotonin Syndrome / diagnosis,  etiology*
Serotonin Uptake Inhibitors / administration & dosage,  toxicity*
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Tricyclic; 0/Serotonin Uptake Inhibitors; 303-49-1/Clomipramine; 61-73-4/Methylene Blue
Comments/Corrections
Comment In:
Psychosomatics. 2010 Sep-Oct;51(5):448-9   [PMID:  20833947 ]

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


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