Serotonin syndrome is a serious drug reaction.
Dr. Carlos A. Ramirez Mongil, from the Pediatric Residency Program of the San Lucas Episcopal Medical Center in Ponce. Photo: Journal of Medicine and Public Health.
Although natural supplements serve as an alternative for the control of certain symptoms associated with various diseases or as vitamin enhancers, the literature warns regarding care in the use of these when a patient take some specific treatmentfor him risk of interaction and toxicity.
Precisely this is the awareness that is generated as a result of a case in Puerto Ricowhere a 16-year-old patient age presented recurrent involuntary movements of the neck with movements eyepieces of the left eye and deviation of the jaw to the left side one day prior to hospital admission at the San Lucas Episcopal Medical Center in Ponce.
Within the clinical history of the patient, depression and anxiety were found for which she was taking escitalopram, an antidepressant medication that inhibits the reuptake of serotonina chemical that is produced naturally by the body and is necessary for nerve cells and the brain to function.
“However, a few days before admission, the mother buys him some natural medicines, recommended by a neighbor, called St. John Wort and the AshwagandhaAlso used to treat depression and anxiety. However, these natural supplements are not always free of side effects, and especially St. John Work has many drug interactions and works in the same place of action that escitalopram works, thus increasing its power of toxicity”, explained the Dr. Carlos A. Ramirez Mongil, of the Pediatric Residency Program of the San Lucas Episcopal Medical Center in Ponceauthor of the case together with Dr. Orlando Torresprofessor of the Ponce Health Science Universityamong others.
St. John Wort is an herb used through capsules, in alternative medicine, as an aid in the treatment of mild depression to moderate, anxiety or insomnia. Meanwhile, Ashwagandha is an evergreen shrub that is commonly used for stress.
“It can be considered that this was the trigger for the syndrome of serotonin in this patient and it is a clinically diagnosed syndrome (…), which causes involuntary movements, usually in the neck, it can also present a state of altered unconsciousness, hyperthermia, among others. The patient was admitted where on physical examination she was noted to be anxious, with myoclonus, involuntary eye movement, and she also had edema in the lower extremities and the reflex of the legs increased”, he added.
Serotonin syndrome is a serious drug reaction. It is due to medications that cause the accumulation of high levels of serotonin in the body.
The patient showed normal levels in studies such as the ECGhead CT, CBC, CMP, among others. The patient was managed with observation and benzodiazepines were administered to calm her state of anxiety and calm her symptoms.
“You should always consult your doctor when you decide to ingest something natural, since it can have interactions with the medications that the patient may be taking. Serotonin syndrome is not only seen in adults, but also in pediatric patients,” she concluded.
