Serotonin syndrome after electroconvulsive therapy for refractory depression

Figures & data

Table 1. Summary of cases with serotonin syndrome after ECT.

Author/reference	Age/sex	Medication prior to ECT	Anesthesia	Onset of symptoms	Symptoms	Treatment
This case	56 F	Lamotrigine, mirtazapine, venlafaxine, levothyroxine	Methohexital	1st ECT session, immediate	Confusion, tachycardia, hypertension, agitation, diaphoresis, mydriasis, clonus, Hoffman's sign	Lorazepam
Okamoto [3]	67 F	Paroxetine, zolpidem, bromazepam	Propofol	1st ECT session, immediate	Tachycardia, Hypertension, Hyperthermia, diaphoresis, myoclonus, tremors, hyperreflexia	Flunitrazepam
Chen [4]	70 F	Trazodone, bupropion, quetiapine	Propofol	1st ECT session, immediate	confusion, agitation, disorganized speech, tachycardia, diaphoresis, myoclonus, hyperreflexia, tremors, mild rigidity	Not specified
Deuschle [5]	45 F	Mirtazapine, quetiapine	Not specified	5th ECT session, 2 day delay	Agitation, auditory/visual hallucinations, tachycardia, hypertension, hyperreflexia	Diazepam, haloperidol

Okamoto N, Sakamoto K, Yamada M. Transient serotonin syndrome by concurrent use of electroconvulsive therapy and selective serotonin reuptake inhibitor: a case report and review of the literature. Case Rep Psychiatry. 2012;215214:1–3. DOI: 10.1155/2012/215214

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Cheng Y-C, Liang C-M, Liu H-C. Serotonin syndrome after electroconvulsive therapy in a patient on trazodone, bupropion, and quetiapine: a case report. Clin Neuropharmacol. 2015;38(3):112–113.

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Deuschle M, Bohringer A, Meyer-Lindenberg A, Sartorius A. Electroconvulsive therapy induces transient sensitivity for a serotonin syndrome: a case report. Pharmacopsychiatry. 2017;50(1):41–42.

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