{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:38Z","timestamp":1787017058884,"version":"build-2736575974"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,5]]},"abstract":"<jats:p>A 14-year-old young adult took an overdose of 1.2 g of fluoxetine, a selective serotonin reuptake inhibitor (SSRI) that he had been prescribed for depression. He had a generalised tonic\/clonic seizure at 6\u2009hours postingestion.<\/jats:p>\n                  <jats:p>After the seizure, he developed signs consistent with serotonin syndrome: fine tremor, agitation, sweating and hyperreflexia. This was followed by severe muscle pain and rhabdomyolysis with peak creatine kinase (CK) of 33\u2009941 at 74\u2009hours. He was managed with intravenous fluids and analgesia and discharged after 4 days, having avoided renal injury. The use of SSRI\u2019s such as fluoxetine in teenagers has increased in recent years. While it is generally considered benign in overdose, this report illustrates the severe consequences of overdose at high quantities and discusses appropriate management in these cases. We note that in this case, there was a delayed onset of rhabdomyolysis with peak CK at 74\u2009hours postingestion.<\/jats:p>","DOI":"10.1136\/bcr-2018-225529","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T02:35:24Z","timestamp":1539052524000},"page":"bcr-2018-225529","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Fluoxetine overdose in a teenager resulting in serotonin syndrome, seizure and delayed onset rhabdomyolysis"],"prefix":"10.1136","volume":"2018","author":[{"given":"Richard","family":"Lee-Kelland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabeeka","family":"Zehra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeesh","family":"Mappa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"issue":"3 Pt 2","key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.1","first-page":"7","article-title":"The pharmacologic profile of fluoxetine","volume":"46","author":"Stark","year":"1985","journal-title":"J Clin Psychiatry"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.2","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.clinthera.2014.06.001","article-title":"Selective serotonin reuptake inhibitors versus tricyclic antidepressants in young patients: a meta-analysis of efficacy and acceptability","volume":"36","author":"Qin","year":"2014","journal-title":"Clin Ther"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.3","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(92)90041-U"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(95)70157-5"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.6","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/S0735-6757(98)90118-8","article-title":"Generalized seizures caused by fluoxetine overdose","volume":"16","author":"Gross","year":"1998","journal-title":"Am J Emerg Med"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.7","doi-asserted-by":"crossref","first-page":"e561","DOI":"10.1097\/MJT.0000000000000196","article-title":"Sertraline-induced rhabdomyolysis: a case report and literature review","volume":"23","author":"Snyder","year":"2016","journal-title":"Am J Ther"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2014.05.005"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2005.07.014"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.10","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120037428"},{"key":"2025042706303299000_2018.oct08_1.bcr-2018-225529.11","doi-asserted-by":"crossref","first-page":"76","DOI":"10.64719\/pb.4100","article-title":"Can fluoxetine alone cause serotonin syndrome in adolescents?","volume":"41","author":"Ghanizadeh","year":"2008","journal-title":"Psychopharmacol Bull"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:04:07Z","timestamp":1775243047000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,8]]},"references-count":11,"alternative-id":["10.1136\/bcr-2018-225529"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225529","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,8]]}}}