精神藥物造成血清素症候群

Drug-induced Serotonin Syndrome

A 43-year-old female patient with a two-year-old history of generalized anxiety disorder, received clinic treatment regularly with daily paroxetine 20 mg, chlorpromazine 100 mg, and clonazepam 2 mg for more than six months. During that time, she visited our clinic numerous times for more prescription drug supplies with complaints of persistent worrying, restlessness, and sleep disturbances. She did not reveal her medication history. She visited different clinics every time and kept asking for more hypnotis. Under the diagnoses of anxiety disorder and de-pressive disorder, several doctors adjusted her medications as propranolol 10 mg BID, zolpi-dem 20 mg QHS, quetiapine 50 mg QHS, mir-tazapine 30 mg QHS, and trazodone 100 mg QHS. One night, she took all medications from two clinics because of her worsened insomnia. Two hours later, she began to have anxiety, rest-lessness, sweating, and chill. Therefore, she was sent to our emergency department with the com-plaints of insomnia, subjective fever, diaphore-sis, tremors, and agitation but with a clear con-sciousness. She denied any serious medical history or substance abuse history.