{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:50:09Z","timestamp":1776948609380,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,7,20]]},"abstract":"<jats:p>Serotonin syndrome (SS) is an iatrogenic, drug-induced syndrome caused by serotoninergic agent. Various serotonergic drugs are used in different headache disorders. Therefore, a possibility of developing SS exists in patients with headache. Herein, we are reporting two patients with headache disorders who developed SS.<\/jats:p>\n               <jats:p>Case 1: a 49-year-old man had a 6-year history of episodic cluster headache (CH). However, he had never been diagnosed with CH before reporting to us. He had been receiving amitriptyline, tramadol\/acetaminophen\u2009combination and flunarizine. Lithium was started for CH. He developed features consistent with SS. The patient responded to cyprohepatdine.<\/jats:p>\n               <jats:p>Case 2: a 36-year-old chronic migraineur was on amitriptyline. Addition of sodium valproate led to the development of new features that fulfilled the criteria of SS. The patient responded to cyprohepatdine.<\/jats:p>\n               <jats:p>As SS may be fatal, there is a need to increase awareness about SS in physicians treating patients with headache.<\/jats:p>","DOI":"10.1136\/bcr-2017-221383","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T10:15:40Z","timestamp":1502100940000},"page":"bcr-2017-221383","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Serotonin syndrome in patients with headache disorders"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-904X","authenticated-orcid":false,"given":"Sanjay","family":"Prakash","sequence":"first","affiliation":[{"name":"Department of Neurology, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, Vadodara, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Banshi","family":"Adroja","sequence":"additional","affiliation":[{"name":"Department of Medicine, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, Vadodara, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haresh","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Smt. B.K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, Vadodara, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,7]]},"reference":[{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg109"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.3","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979491"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.4","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.5","first-page":"2229","article-title":"Preventability and severity assessment in reporting adverse drug reactions","volume":"49","author":"Hartwig","year":"1992","journal-title":"Am J Hosp Pharm"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.11.016"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.7","first-page":"421","article-title":"Drug interactions due to cytochrome P450","volume":"13","author":"Ogu","year":"2000","journal-title":"Proc"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(98)00161-9"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.9","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0022-3565(25)28963-7","article-title":"Stimulation of serotonin synthesis by lithium","volume":"178","author":"Perez-Cruet","year":"1971","journal-title":"J Pharmacol Exp Ther"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.10","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-199608060-00008"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/00004850-199612000-00013","article-title":"A case of serotonin syndrome induced by concomitant treatment with low-dose trazodone and amitriptyline and lithium","volume":"11","author":"Nisijima","year":"1996","journal-title":"Int Clin Psychopharmacol"},{"key":"2025082701205018000_2017.aug07_1.bcr-2017-221383.12","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4103\/0972-2327.150612","article-title":"Mild serotonin syndrome: a report of 12 cases","volume":"18","author":"Prakash","year":"2015","journal-title":"Ann Indian Acad Neurol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:21:00Z","timestamp":1756282860000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,7]]},"references-count":12,"alternative-id":["10.1136\/bcr-2017-221383"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221383","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,7]]}}}