Serotonin Syndrome: A Case Study

To monitor for efficacy in this case, I would expect the patient to take 20 mg of fluoxetine daily for 2-4 weeks and return for a follow-up visit, where she indicate if her symptoms have either resolved or improved. To monitor for toxicity, I would want to look for symptoms of serotonin syndrome. Serotonin syndrome occurs due to serotonergic drug use and excitability of peripheral and central postsynaptic 5HT-1A and 5Ht-2A receptors (Volpi-Abadie, Kaye, & Kaye, 2013). Serotonin syndrome symptoms can occur approximately 24 hours after a dosage increase, adding a serotonergic agent and overdose (Volpi-Abadie et al., 2013). Symptoms can range from mild to severe and can include: tachycardia, tremors, diaphoresis, hyperthermia, and delirium (Volpi-Abadie et al., 2013). Other adverse effects to watch for while taking an SSRI are increase suicidal thoughts and ideation, sexual dysfunction, and aggressive behaviors (Wenthur, Bennett, & Lindsley, 2014). SSRIs can affect the liver and kidneys. If she were to begin experiencing problems related to kidney or liver function such as, jaundice or decreased urine output, a renal and liver function panel would be appropriate. If Barbara returns to the office for a follow-up and there is no adequate response I would up her dosage another 10 mg to 30 mg. I …show more content…
Discontinuation syndrome symptoms include sensory and gastrointestinal (GI) symptoms along with changes in sleep, lethargy, and dizziness (Renoir, 2013). These symptoms can occur within a week after stopping an SSRI (Renoir, 2013). In order to avoid discontinuation syndrome, the patient should have her medication decreased slowly for a successful wean off the medication. This will allow her to begin a new medication regimen and preserve her health. She should still be closely monitored while being weaned off the SSRI to ensure that she is not experiencing discontinuation