An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT
Serotonin syndrome is a toxidrome consisting of autonomic instability, altered mentation, hyperreflexia, clonus, and seizures. It is suspected to be due to either elevated serotonin concentrations or overstimulation of 5-hydroxytryptamine (5-HT) receptors. There are at least seven families of seroto...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
|
| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2024/6938553 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841561410578939904 |
|---|---|
| author | Shahzaib Khan Breanna Wennberg Malgorzata Witkowska Jacob Rattin Raunak Khisty |
| author_facet | Shahzaib Khan Breanna Wennberg Malgorzata Witkowska Jacob Rattin Raunak Khisty |
| author_sort | Shahzaib Khan |
| collection | DOAJ |
| description | Serotonin syndrome is a toxidrome consisting of autonomic instability, altered mentation, hyperreflexia, clonus, and seizures. It is suspected to be due to either elevated serotonin concentrations or overstimulation of 5-hydroxytryptamine (5-HT) receptors. There are at least seven families of serotonin or 5-HT receptors along with multiple subtypes. The 5-HT1A and 5-HT2A serotonin receptor subtypes are heavily suspected to cause the broad spectrum of symptoms seen in serotonin syndrome. We present the case of a young woman treated with multiple psychotropic medications who developed serotonin syndrome (SS) after receiving electroconvulsive therapy (ECT). She had multiple psychiatric hospitalizations, and ECT was determined to be the appropriate course of treatment due to her treatment-resistant symptoms and catatonia. The case was unique as she tolerated multiple ECT treatments over a few weeks before the acute onset of serotonin syndrome following her eighth treatment, and she did not have any medication changes after the second ECT treatment. The patient’s acute presentation of rigidity, elevated temperature, hyperreflexia, diaphoresis, confusion, and psychomotor agitation led to a diagnosis of serotonin syndrome. ECT is a neuromodulatory procedure approved for treatment-resistant depression and schizophrenia that involves electrically stimulating the brain with electrodes on the scalp to induce a seizure. The mechanism by which ECT confers therapeutic benefit for patients with neuropsychiatric conditions is not entirely understood. We discuss some of the literature on SS and ECT to better understand the potential for a causal relationship. |
| format | Article |
| id | doaj-art-5efa9f1e372c466da871f20d973f8fba |
| institution | Kabale University |
| issn | 2090-6838 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-5efa9f1e372c466da871f20d973f8fba2025-01-03T01:41:15ZengWileyCase Reports in Psychiatry2090-68382024-01-01202410.1155/2024/6938553An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECTShahzaib Khan0Breanna Wennberg1Malgorzata Witkowska2Jacob Rattin3Raunak Khisty4Riverside Medical CenterRiverside Medical CenterRiverside Medical CenterCleveland Clinic FoundationRiverside Medical CenterSerotonin syndrome is a toxidrome consisting of autonomic instability, altered mentation, hyperreflexia, clonus, and seizures. It is suspected to be due to either elevated serotonin concentrations or overstimulation of 5-hydroxytryptamine (5-HT) receptors. There are at least seven families of serotonin or 5-HT receptors along with multiple subtypes. The 5-HT1A and 5-HT2A serotonin receptor subtypes are heavily suspected to cause the broad spectrum of symptoms seen in serotonin syndrome. We present the case of a young woman treated with multiple psychotropic medications who developed serotonin syndrome (SS) after receiving electroconvulsive therapy (ECT). She had multiple psychiatric hospitalizations, and ECT was determined to be the appropriate course of treatment due to her treatment-resistant symptoms and catatonia. The case was unique as she tolerated multiple ECT treatments over a few weeks before the acute onset of serotonin syndrome following her eighth treatment, and she did not have any medication changes after the second ECT treatment. The patient’s acute presentation of rigidity, elevated temperature, hyperreflexia, diaphoresis, confusion, and psychomotor agitation led to a diagnosis of serotonin syndrome. ECT is a neuromodulatory procedure approved for treatment-resistant depression and schizophrenia that involves electrically stimulating the brain with electrodes on the scalp to induce a seizure. The mechanism by which ECT confers therapeutic benefit for patients with neuropsychiatric conditions is not entirely understood. We discuss some of the literature on SS and ECT to better understand the potential for a causal relationship.http://dx.doi.org/10.1155/2024/6938553 |
| spellingShingle | Shahzaib Khan Breanna Wennberg Malgorzata Witkowska Jacob Rattin Raunak Khisty An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT Case Reports in Psychiatry |
| title | An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT |
| title_full | An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT |
| title_fullStr | An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT |
| title_full_unstemmed | An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT |
| title_short | An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT |
| title_sort | unexpected presentation of serotonin syndrome in a patient receiving ect |
| url | http://dx.doi.org/10.1155/2024/6938553 |
| work_keys_str_mv | AT shahzaibkhan anunexpectedpresentationofserotoninsyndromeinapatientreceivingect AT breannawennberg anunexpectedpresentationofserotoninsyndromeinapatientreceivingect AT malgorzatawitkowska anunexpectedpresentationofserotoninsyndromeinapatientreceivingect AT jacobrattin anunexpectedpresentationofserotoninsyndromeinapatientreceivingect AT raunakkhisty anunexpectedpresentationofserotoninsyndromeinapatientreceivingect AT shahzaibkhan unexpectedpresentationofserotoninsyndromeinapatientreceivingect AT breannawennberg unexpectedpresentationofserotoninsyndromeinapatientreceivingect AT malgorzatawitkowska unexpectedpresentationofserotoninsyndromeinapatientreceivingect AT jacobrattin unexpectedpresentationofserotoninsyndromeinapatientreceivingect AT raunakkhisty unexpectedpresentationofserotoninsyndromeinapatientreceivingect |