{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:22:48Z","timestamp":1791084168633,"version":"4.1.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,4,28]],"date-time":"2019-04-28T00:00:00Z","timestamp":1556409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with several indications, one of which is for depression. We present a case of probable paroxetine-induced serotonin syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary:<\/jats:title>\n                    <jats:p>A 21-year-old female with a history of generalized anxiety disorder and major depression presented with increased depressive symptoms over several months while taking fluoxetine 20 mg daily. Fluoxetine was discontinued without taper and replaced with paroxetine 10 mg daily, along with hydroxyzine 50 mg twice daily as needed for anxiety. Within a week of starting the paroxetine, the patient reported increased anxiety, insomnia, and constant shaking. The paroxetine continued to be uptitrated over a 3-week period to a dose 30 mg due to unremitting depressive symptoms. One month later, the patient presented with tachycardia, generalized body aches, extreme fatigue, weakness, uncontrollable twitching, tremor, and hyperreflexia. A widespread burning sensation accompanied by random hot flashes without diaphoresis was also noted. Serotonin syndrome was diagnosed using the Hunters criteria. Paroxetine was discontinued, and the patient\u2019s physical symptoms resolved within a week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>To date, only 5 cases of serotonin syndrome have been reported in patients receiving SSRI monotherapy at recommended therapeutic doses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0897190019841742","type":"journal-article","created":{"date-parts":[[2019,4,28]],"date-time":"2019-04-28T23:13:11Z","timestamp":1556493191000},"page":"206-212","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["A Case Report of Serotonin Syndrome in a Patient on Selective Serotonin Reuptake Inhibitor (SSRI) Monotherapy"],"prefix":"10.1177","volume":"33","author":[{"given":"Timothy R.","family":"Hudd","sequence":"first","affiliation":[{"name":"Pharmacy Practice, MCPHS University, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie S.","family":"Blake","sequence":"additional","affiliation":[{"name":"Private Practice, Reading, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahiada","family":"Rimola-Dejesus","sequence":"additional","affiliation":[{"name":"Lahey Clinic, North Andover, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thu-Trang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"MCPHS University, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Zaiken","sequence":"additional","affiliation":[{"name":"Pharmacy Practice, MCPHS University, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,4,28]]},"reference":[{"key":"bibr1-0897190019841742","first-page":"1","volume":"283","author":"Pratt LA","year":"2017","journal-title":"NCHS Data Brief"},{"key":"bibr2-0897190019841742","doi-asserted-by":"publisher","DOI":"10.2174\/092986712800099749"},{"key":"bibr3-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"bibr4-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1D352"},{"key":"bibr5-0897190019841742","unstructured":"Boyer EW. Serotonin syndrome (serotonin toxicity). In: Traub SJ, Grayzel J, eds. UpToDate. [Internet]. Waltham, MA: UpToDate; 2018. www.uptodate.com. 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MHAUS. https:\/\/www.mhaus.org\/nmsis\/medical-education-programs\/serotonin-syndrome\/. Accessed June 17, 2018."},{"key":"bibr15-0897190019841742","unstructured":"DynaMed Plus [Internet]. Ipswich (MA): EBSCO Information Services. 1995. Record No. 193270, Serotonin syndrome; 2018. http:\/\/www.dynamed.com\/login.aspx?direct=true&site=DynaMed&id=193270. Registration and login required. 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Research Triangle Park, NC: GlaxoSmithKline, 2013. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2014\/020031s071,020710s035lbl.pdf Updated June 2014; Accessed September 09, 2018."},{"key":"bibr21-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-3458.2001.tb00189.x"},{"issue":"3","key":"bibr22-0897190019841742","first-page":"76","volume":"39","author":"Keks N","year":"2016","journal-title":"Aust Prescr"},{"key":"bibr23-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1177\/0897190012467210"},{"key":"bibr24-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199706000-00012"},{"key":"bibr25-0897190019841742","unstructured":"Prozac (fluoxetine) delayed-release capsules [package insert on the Internet]. Indianapolis, IN: Eli Lilly and Company; 1987. http:\/\/pi.lilly.com\/us\/prozac.pdf Updated March 2017; Accessed September 09, 2018."},{"key":"bibr26-0897190019841742","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2017169"},{"issue":"7","key":"bibr27-0897190019841742","first-page":"988","volume":"54","author":"Frank C","year":"2008","journal-title":"Can Fam Physician"},{"key":"bibr28-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-4679(98)00057-2"},{"key":"bibr29-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200007000-00001"},{"key":"bibr30-0897190019841742","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.148.6.705"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190019841742","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0897190019841742","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190019841742","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:35:28Z","timestamp":1777509328000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0897190019841742"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,28]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1177\/0897190019841742"],"URL":"https:\/\/doi.org\/10.1177\/0897190019841742","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,28]]}}}