{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T04:55:42Z","timestamp":1770785742515,"version":"3.50.0"},"reference-count":50,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Serotonin-related adverse drug reactions (ADRs) of selective serotonin reuptake inhibitors, including serotonin toxicity (ST) and antidepressant discontinuation syndrome (ADS), may significantly affect adherence to antidepressant therapy. ST is a rare but potentially serious adverse drug reaction resulting from excessive serotonergic activity, while ADS may occur after the abrupt discontinuation or dose reduction of an antidepressant. Both complications may be influenced by pharmacokinetic and pharmacogenetic (PGx) factors, although research on these relationships is limited. This case report describes a 40-year-old, medically healthy patient identified to be a\n                    <jats:italic>CYP2C19 *2\/*2<\/jats:italic>\n                    poor metabolizer (PM) who potentially experienced ST and prolonged ADS following treatment with escitalopram. After starting escitalopram while on buspirone and stimulant medications, she developed symptoms consistent with ST, including agitation, confusion, diarrhea, and muscle rigidity, leading to discontinuation. A retrial of escitalopram after 3 weeks resulted in similar symptoms. Despite ongoing ST-like symptoms, the patient chooses to continue escitalopram for 2 years, given her perceived benefits with treatment. Upon discontinuation after being on escitalopram for more than 2 years, the patient experienced prolonged withdrawal symptoms consistent with ADS. This case highlights the utility of pre-emptive PGx testing in antidepressant therapy and the importance of interprofessional care in enhancing the patient\u2019s self-efficacy.\n                  <\/jats:p>","DOI":"10.9740\/mhc.2026.02.026","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:55:16Z","timestamp":1770137716000},"page":"26-29","source":"Crossref","is-referenced-by-count":0,"title":["Protracted escitalopram discontinuation syndrome and serotonin toxicity associated with CYP2C19 poor metabolism: A case report"],"prefix":"10.9740","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2301-1285","authenticated-orcid":true,"given":"Elizabeth H.","family":"Tran","sequence":"first","affiliation":[{"name":"(Corresponding author) Clinical Research and Education Project Manager, University of Minnesota College of Pharmacy, Duluth, Minnesota, tran0495.d@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7653-8980","authenticated-orcid":true,"given":"Jeffrey R.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Professor, Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesot"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3953-1058","authenticated-orcid":true,"given":"Jacob T.","family":"Brown","sequence":"additional","affiliation":[{"name":"Associate Professor, University of Minnesota College of Pharmacy, Duluth, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0234-7370","authenticated-orcid":true,"given":"Sarah J.","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Medical Director, Human Development Center, Duluth, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4239-3354","authenticated-orcid":true,"given":"Mark E.","family":"Schneiderhan","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Pharmacy Practice and Pharmaceutical Sciences, Duluth, Minnesota; University of Minnesota College of Pharmacy, Minneapolis, Minnesota; Department of Psychiatry, Human Development Center, Duluth, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"issue":"2","key":"i2168-9709-16-1-26-b01","series-title":"J Psychopharmacol","first-page":"127","article-title":"What is the impact of antidepressant side effects on medication adherence among adult patients diagnosed with depressive disorder: a systematic review","volume":"38","author":"Niarchou","year":"2024","unstructured":"Niarchou E,\nRoberts L,\nNaughton BD. What is the impact of antidepressant side effects on medication adherence among adult patients diagnosed with depressive disorder: a systematic review. J Psychopharmacol. 2024;38(2):127-36. DOI: 10.1177\/02698811231224171"},{"key":"i2168-9709-16-1-26-b02","series-title":"Int J Tryptophan Res","first-page":"1178646919873925","article-title":"Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions","volume":"12","author":"Scotton","year":"2019","unstructured":"Scotton WJ,\nHill LJ,\nWilliams AC,\nBarnes NM. Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions. Int J Tryptophan Res. 2019;12:1178646919873925. 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American Psychiatric Association; 2022."},{"issue":"6","key":"i2168-9709-16-1-26-b08","series-title":"Prim Care Companion CNS Disord","first-page":"18m02311","article-title":"Brain zaps: an underappreciated symptom of antidepressant discontinuation","volume":"20","author":"Papp","year":"2018","unstructured":"Papp A,\nOnton JA. Brain zaps: an underappreciated symptom of antidepressant discontinuation. Prim Care Companion CNS Disord. 2018;20(6):18m02311. DOI: 10.4088\/PCC.18m02311"},{"key":"i2168-9709-16-1-26-b09","series-title":"Addict Behav","first-page":"111","article-title":"A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: are guidelines evidence-based","volume":"97","author":"Davies","year":"2019","unstructured":"Davies J,\nRead J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: are guidelines evidence-based? Addict Behav. 2019;97:111-21. 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PMID: 39294572; PMCID: PMC11409801."},{"issue":"1-02","key":"i2168-9709-16-1-26-b22","series-title":"Pharmacopsychiatry","first-page":"9","article-title":"Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017","volume":"51","author":"Hiemke","year":"2018","unstructured":"Hiemke C,\nBergemann N,\nClement HW,\nConca A,\nDeckert J,\nDomschke K, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51(1-02):9-62. Erratum in: Pharmacopsychiatry. 2018;51(1-02):e1. DOI: 10.1055\/s-0037-1600991"},{"issue":"1","key":"i2168-9709-16-1-26-b23","series-title":"Ann Fam Med","first-page":"52","article-title":"Managing antidepressant discontinuation: a systematic review","volume":"17","author":"Maund","year":"2019","unstructured":"Maund E,\nStuart B,\nMoore M,\nDowrick C,\nGeraghty AWA,\nDawson S, et al. Managing antidepressant discontinuation: a systematic review. 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DOI: 10.1097\/WNF.0000000000000139"},{"issue":"2","key":"i2168-9709-16-1-26-b01","series-title":"J Psychopharmacol","first-page":"127","article-title":"What is the impact of antidepressant side effects on medication adherence among adult patients diagnosed with depressive disorder: a systematic review","volume":"38","author":"Niarchou","year":"2024","unstructured":"Niarchou E,\nRoberts L,\nNaughton BD. What is the impact of antidepressant side effects on medication adherence among adult patients diagnosed with depressive disorder: a systematic review. J Psychopharmacol. 2024;38(2):127-36. DOI: 10.1177\/02698811231224171"},{"key":"i2168-9709-16-1-26-b02","series-title":"Int J Tryptophan Res","first-page":"1178646919873925","article-title":"Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions","volume":"12","author":"Scotton","year":"2019","unstructured":"Scotton WJ,\nHill LJ,\nWilliams AC,\nBarnes NM. 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DOI: 10.1016\/j.addbeh.2018.08.027"},{"key":"i2168-9709-16-1-26-b10","series-title":"Ther Adv Psychopharmacol","first-page":"2045125320980573","article-title":"Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum","volume":"10","author":"Hengartner","year":"2020","unstructured":"Hengartner MP,\nSchulthess L,\nSorensen A,\nFramer A. Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum. Ther Adv Psychopharmacol. 2020;10:2045125320980573. 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PMID: 24358002"},{"issue":"4","key":"i2168-9709-16-1-26-b13","series-title":"J Psychiatry Neurosci","first-page":"E7","article-title":"Recognition and management of antidepressant discontinuation syndrome","volume":"42","author":"Bhat","year":"2017","unstructured":"Bhat V,\nKennedy SH. Recognition and management of antidepressant discontinuation syndrome. J Psychiatry Neurosci. 2017;42(4):E7-8. DOI: 10.1503\/jpn.170022"},{"issue":"1","key":"i2168-9709-16-1-26-b14","series-title":"Clin Pharmacol Ther","first-page":"51","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A genotypes and serotonin reuptake inhibitor antidepressants","volume":"114","author":"Bousman","year":"2023","unstructured":"Bousman CA,\nStevenson JM,\nRamsey LB,\nSangkuhl K,\nHicks JK,\nStrawn JR, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A genotypes and serotonin reuptake inhibitor antidepressants. Clin Pharmacol Ther. 2023;114(1):51-68. DOI: 10.1002\/cpt.2903"},{"issue":"4","key":"i2168-9709-16-1-26-b15","series-title":"Pharmacogenomics","first-page":"537","article-title":"Genetic polymorphisms of cytochrome P450 enzymes influence metabolism of the antidepressant escitalopram and treatment response","volume":"11","author":"Tsai","year":"2010","unstructured":"Tsai MH,\nLin KM,\nHsiao MC,\nShen WW,\nLu ML,\nTang HS, et al. Genetic polymorphisms of cytochrome P450 enzymes influence metabolism of the antidepressant escitalopram and treatment response. Pharmacogenomics. 2010;11(4):537-46. DOI: 10.2217\/pgs.09.168"},{"issue":"5","key":"i2168-9709-16-1-26-b16","series-title":"Am J Psychiatry","first-page":"463","article-title":"Impact of CYP2C19 genotype on escitalopram exposure and therapeutic failure: a retrospective study based on 2,087 patients","volume":"175","author":"Juki\u0107","year":"2018","unstructured":"Juki\u0107 MM,\nHaslemo T,\nMolden E,\nIngelman-Sundberg M. Impact of CYP2C19 genotype on escitalopram exposure and therapeutic failure: a retrospective study based on 2,087 patients. Am J Psychiatry. 2018;175(5):463-70. 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