Serotonin syndrome is a serious drug reaction.
Dr. Carlos A. Ramirez Mongil, from the Pediatric Residency Program of the San Lucas Episcopal Medical Center in Ponce. Photo: Journal of Medicine and Public Health.
Although natural supplements serve as an alternative for the control of certain symptoms associated with various diseases or as vitamin enhancers, the literature warns about care in their use when a patient takes a specific treatment, due to the risk of interaction and toxicity. .
Precisely this is the awareness that is generated as a result of a case in Puerto Rico, where a 16-year-old patient presented recurrent involuntary movements of the neck with ocular movements of the left eye and deviation of the jaw to the left side one day prior to hospital admission at the San Lucas Episcopal Medical Center in Ponce.
Within the clinical history of the patient, depression and anxiety were found for which she was taking escitalopram, an antidepressant drug that inhibits the reuptake of serotonin, a chemical that the body produces naturally and is necessary for nerve cells and the brain to function.
“However, a few days before admission, the mother buys him some natural medicines, recommended by a neighbor, called St. John Work and Ashwagandha, also used to treat depression and anxiety. However, these natural supplements are not always free of side effects and especially the St. John Work has many drug interactions and works at the same site of action as escitalopram, thus increasing its toxicity power”, explained the Dr. Carlos A. Ramirez Mongil, of the Pediatric Residency Program of the San Lucas Episcopal Medical Center in Ponceauthor of the case together with Dr. Orlando Torres, professor at Ponce Health Science University, among others.
St. John Work is an herb used via capsules, in alternative medicine, as an aid in the treatment of mild to moderate depression, anxiety, or insomnia. Meanwhile, Ashwagandha is an evergreen shrub that is commonly used for stress.
“It can be considered that this was the trigger for serotonin syndrome in this patient and it is a clinically diagnosed syndrome (…), which causes involuntary movements, usually in the neck, it can also present a state of altered unconsciousness, hyperthermia, among others. others. The patient was admitted where on physical examination she was noted to be anxious, with myoclonus, involuntary eye movement, and she also had lower extremity edema and increased leg reflexes”, she added.
Serotonin syndrome is a serious drug reaction. It is due to medications that cause the accumulation of high levels of serotonin in the body.
The patient showed normal levels in studies such as ECG, head CT, CBC, CMP, among others. The patient was managed with observation and benzodiazepines were administered to calm her state of anxiety and calm her symptoms.
“You should always consult your doctor when you decide to ingest something natural, since it can have interactions with the medications that the patient may be taking. Serotonin syndrome is not only seen in adults, but also in pediatric patients,” she concluded.
See the case presentation here: