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Serotonin syndrome associated with metaxalone overdose.

AbstractINTRODUCTION:
Serotonin syndrome is a potentially life-threatening entity associated with pro-serotonergic medications in therapeutic use, in overdose, or when co-administered with other drugs. A broad range of drugs and drug combinations have been associated with serotonin syndrome. Metaxalone overdose associated with serotonin syndrome has not been previously reported.
CASE REPORT:
(Case 1) A 23-year-old female overdosed on tramadol and metaxalone. She developed dysautonomia, diaphoresis, lower extremity rigidity and spontaneous clonus, flaccid upper extremities, and hyperthermia 5 h after ingestion. Her course was complicated by status epilepticus. (Case 2) A 56-year-old female overdosed on metaxalone and was found unresponsive. She developed dysautonomia, lower extremity rigidity and spontaneous clonus, flaccid upper extremities, rhabdomyolysis, acute renal failure, and hyperthermia. Non-depolarizing neuromuscular blockade and cooling blankets were required to control hyperthermia in both cases. Serum metaxalone levels were markedly elevated in both cases.
CONCLUSION:
These are the first reported cases of metaxalone overdose associated with serotonin syndrome, which may be related to monoamine oxidase inhibition.
AuthorsAdam R Bosak, Aaron B Skolnik
JournalJournal of medical toxicology : official journal of the American College of Medical Toxicology (J Med Toxicol) Vol. 10 Issue 4 Pg. 402-5 (Dec 2014) ISSN: 1937-6995 [Electronic] United States
PMID24805103 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Neuromuscular Agents
  • Oxazolidinones
  • metaxalone
Topics
  • Adult
  • Drug Overdose (complications)
  • Female
  • Humans
  • Middle Aged
  • Neuromuscular Agents (poisoning)
  • Oxazolidinones (poisoning)
  • Serotonin Syndrome (chemically induced)

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