JRH was thankful for the advice and thankful, too, for the broadening of his horizons. She had been given 60 mg per day of fluoxetine. Within two to three weeks of starting the medication, she began to have tremors, muscle rigidity, mental status changes and low-grade fever. WLL immediately discontinued the fluoxetine, and all symptoms resolved in three to five days. Serotonin syndrome is a potentially lethal disorder that is believed to be very similar clinically to neuroleptic malignant syndrome.
Primary symptoms are fever, muscular rigidity, mental status changes and seizures.
It occurs when one or more drugs affecting serotonin activity are administered. Cyproheptadine has been shown to be a useful drug in reversing symptoms. About four months ago, this patient had presented with a similar problem, but during the course of the evaluation, she had mentioned that she had some feelings of pressure in her neck for quite some time. SEF discovered a mild goiter and started a thyroid evaluation. She was euthyroid but had a cold nodule on thyroid scan.