{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T20:02:20Z","timestamp":1764014540337,"version":"3.45.0"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Serotonin syndrome (SS) is a potentially life-threatening condition caused by excessive serotonergic activity in the central nervous system. It is commonly linked to combinations of serotonergic prescription drugs; however, over-the-counter or prescription cold medications containing dextromethorphan (DM) or first-generation antihistamines may also pose a risk. We report a case of a 52-year-old male on sertraline who developed SS after taking Bromfed DM, a cough syrup containing brompheniramine, pseudoephedrine, and DM. Three days after starting the medication, he experienced confusion, dilated pupils, myoclonic foot movements, and difficulty with speech. Symptoms improved following the discontinuation of both sertraline and Bromfed DM. This case underscores the importance of recognizing the serotonergic potential of common cold medications and the risk of SS even at therapeutic doses, particularly in patients on selective serotonin reuptake inhibitors (SSRIs). Prompt identification and cessation of the causative agents are critical to avoid complications.<\/jats:p>","DOI":"10.1177\/2050313x251392069","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T08:44:06Z","timestamp":1763628246000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serotonin syndrome induced by Bromfed DM in a patient on sertraline"],"prefix":"10.1177","volume":"13","author":[{"given":"John K.","family":"Jung","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5544-0594","authenticated-orcid":false,"given":"Ismail","family":"Zazay","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9682-365X","authenticated-orcid":false,"given":"James R.","family":"Burmeister","sequence":"additional","affiliation":[{"name":"Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neda","family":"Shaghaghi","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg109"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650701668625"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20092288"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03747.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-221486"},{"issue":"10","key":"e_1_3_3_8_2","first-page":"720","article-title":"Demystifying serotonin syndrome (or serotonin toxicity)","volume":"64","author":"Foong AL","year":"2018","unstructured":"Foong AL, Grindrod KA, Patel T, et al Demystifying serotonin syndrome (or serotonin toxicity). Can Fam Physician 2018; 64(10): 720\u2013727.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_9_2","volume-title":"StatPearls [Internet]","author":"Simon LV","year":"2024","unstructured":"Simon LV, Torrico TJ, Keenaghan M. Serotonin syndrome. In: StatPearls [Internet]. StatPearls Publishing, 2024."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-8206.1998.tb00976.x"},{"issue":"6","key":"e_1_3_3_11_2","article-title":"Serotonin syndrome in a sertraline-treated man taking NyQuil","volume":"14","author":"Sethi R","year":"2012","unstructured":"Sethi R, Kablinger AS, Kavuru B. Serotonin syndrome in a sertraline-treated man taking NyQuil. Prim Care Companion CNS Disord 2012; 14(6): PCC.12l01388.","journal-title":"Prim Care Companion CNS Disord"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251392069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X251392069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251392069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T19:22:16Z","timestamp":1764012136000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X251392069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":10,"alternative-id":["10.1177\/2050313X251392069"],"URL":"https:\/\/doi.org\/10.1177\/2050313x251392069","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"type":"print","value":"2050-313X"},{"type":"electronic","value":"2050-313X"}],"subject":[],"published":{"date-parts":[[2025,11]]},"article-number":"2050313X251392069"}}