{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:23:45Z","timestamp":1777418625502,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[1998,4,1]],"date-time":"1998-04-01T00:00:00Z","timestamp":891388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To document a case of serotonin syndrome associated with venlafaxine and fluoxetine that did not involve a monoamine oxidase inhibitor, and to examine the multiple factors, including pharmacodynamic and pharmacokinetic interactions, that likely caused this adverse drug reaction (ADR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 39-year-old white woman with depression and panic attacks was being treated with fluoxetine, trazodone, clonazepam, and cimetidine. After fluoxetine and clonazepam were abruptly discontinued, venlafaxine and lorazepam were started. Within 24 hours, she developed diaphoresis, tremors, slurred speech, myoclonus, restlessness, impaired thinking, and diarrhea. This constellation meets Sternbach's criteria for serotonin syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>The possible contributors to this ADR are discussed, including a single drug effect (e.g., an idiosyncratic reaction to venlafaxine), a pharmacokinetic interaction, a pharmacodynamic interaction, a combined pharmacokinetic\u2013pharmacodynamic interaction, and the patient's panic disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>As more serotonergic drugs are developed and used for psychiatric disorders, frequently in combination or close temporal proximity, clinicians must be aware of and consider the factors that may increase the risk of patients experiencing serotonin syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Documentar un caso de s\u00edndrome de serotonina asociado a venlafaxin que no involucra un inhibidor de monoaminaoxidasa y examinar los factores m\u00faltiples, incluyendo interacciones farmacodin\u00e1micas y farmacocin\u00e9ticas que pudieron causar esta reacci\u00f3n adversa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN:<\/jats:title>\n                    <jats:p>Una mujer deprimida de 39 a\u00f1os estaba recibiendo fluoxetin, trazodon, clonazepam, y cimetidina. Despu\u00e9s que fluoxetin y clonazepam fueron descontinuados abruptamente, se le empez\u00f3 a administrar venlafaxin y lorazepam. Dentro de las 24 horas, desarroll\u00f3 diaforesis, temblores, problemas del habla, mioclono, inquietud, problemas en concentrarse, y diarrea. Esta presentaci\u00f3n llena los criterios de Sternbach para s\u00edndrome de serotonina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSI\u00d3N:<\/jats:title>\n                    <jats:p>Se discuten los posibles contribuyentes para esta reacci\u00f3n adversa incluyendo el efecto a un solo medicamento (e.g., reacci\u00f3n idiosincr\u00e1tica a venlafaxin), interacci\u00f3n farmacocin\u00e9tica, interacci\u00f3n farmacodin\u00e1mica, una interacci\u00f3n farmacocin\u00e9ticafarmacodin\u00e1mica combinada, y el desorden de p\u00e1nico que sufr\u00eda la paciente.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>Seg\u00fan se desarrollen y se utilicen m\u00e1s f\u00e1rmacos seroton\u00e9rgicos para varios des\u00f3rdenes siqui\u00e1tricos, frecuentemente en combinaci\u00f3n o cerca uno del otro, los m\u00e9dicos deben estar atentos y considerar todos los factores potenciales que pueden aumentar el riesgo a pacientes de padecer un s\u00eddrome de serotonina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>Pr\u00e9senter un cas de syndrome s\u00e9rotoninergique associ\u00e9 \u00e0 l'utilisation de venlafaxine seule, sans inhibiteur de la monoamine oxydase, et examiner les multiples facteurs, incluant les interactions pharmacodynamiques et pharmacocin\u00e9tiques, qui ont possiblement contribu\u00e9 \u00e0 l'apparition de cette r\u00e9action ind\u00e9sirable au m\u00e9dicament.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DU CAS:<\/jats:title>\n                    <jats:p>Une femme de 39 ans, atteinte de d\u00e9pression, \u00e9tait trait\u00e9e avec de la fluox\u00e9tine, de la trazodone, du clonaz\u00e9pam, et de la cim\u00e9tidine. Apr\u00e8s l'arr\u00eat subit de la fluox\u00e9tine et de clonaz\u00e9pam, on a d\u00e9but\u00e9 un traitement avec la venlafaxine et du loraz\u00e9pam. En 24 heures, la patiente a d\u00e9velopp\u00e9 de la diaphor\u00e8se, des tremblements, des difficult\u00e9s d'\u00e9locution, de la myoclonie, de l'agitation psychomotrice, une alt\u00e9ration de la pens\u00e9e, et de la diarh\u00e9e. Cette pr\u00e9sentation clinique rencontre les crit\u00e8res de Sternbach d\u00e9finissant le syndrome s\u00e9rotoninergique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Les \u00e9l\u00e9ments ayant pu contribuer \u00e0 cette r\u00e9action ind\u00e9sirable au m\u00e9dicament sont discut\u00e9s dans cet article et ils comprennent l'effet d'un seul m\u00e9dicament (e.g., une r\u00e9action idiosyncrasique \u00e0 la venlafaxine), une interaction pharmacocin\u00e9tique et\/ou pharmacodynamique, et un trouble de panique sous-jacent chez cette patiente.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>De plus en plus de m\u00e9dicaments s\u00e9rotoninergiques sont d\u00e9velopp\u00e9s et employ\u00e9s dans divers d\u00e9sordres psychiatriques, ceux-ci sont fr\u00e9quemment utilis\u00e9s en association ou de fa\u00e7on successive, un agent \u00e9tant d\u00e9but\u00e9 peu apr\u00e8s l'arr\u00eat d'un autre. Ainsi, les cliniciens doivent conna\u00eetre et consid\u00e9rer tous les facteurs potentiels pouvant accro\u00eetre le risque que ces patients d\u00e9veloppent un syndrome s\u00e9rotoninergique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17041","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"432-436","source":"Crossref","is-referenced-by-count":29,"title":["Serotonin Syndrome Induced by Venlafaxine and Fluoxetine: A Case Study in Polypharmacy and Potential Pharmacodynamic and Pharmacokinetic Mechanisms"],"prefix":"10.1177","volume":"32","author":[{"given":"Vinod S","family":"Bhatara","sequence":"first","affiliation":[{"name":"Vinod S Bhatara MS MD, Associate Professor and Co-Director of Child Psychiatry, University of South Dakota School of Medicine, Sioux Falls, SD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan D","family":"Magnus","sequence":"additional","affiliation":[{"name":"Ryan D Magnus MD, Associate Medical Director, Psychiatric Research Institute, and Department of Psychiatry, University of Kansas School of Medicine at Wichita, Wichita, KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K Lynn","family":"Paul","sequence":"additional","affiliation":[{"name":"K Lynn Paul MD, Associate Professor and Residency Director, University of South Dakota School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon H","family":"Preskorn","sequence":"additional","affiliation":[{"name":"Sheldon H Preskorn MD, Director, Psychiatric Research Institute, and Professor and Vice Chairman, Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine at Wichita"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1998,4,1]]},"reference":[{"key":"bibr1-aph.17041","unstructured":"Wyeth-Ayerst Laboratories. 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