Serotonin syndrome after an overdose of over-the-counter medicine containing dextromethorphan

Published on Jun 4, 2021in Journal of General and Family Medicine
· DOI :10.1002/JGF2.469
Nina Omoto , Yohei Kanzawa2
Estimated H-index: 2
+ 1 AuthorsSaori Kinami4
Estimated H-index: 4
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Abstract Background The evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guideline Cough due to Acute Bronchitis. Methods Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any rec...
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Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. Most reported cases of serotonin syndrome are in patients using multiple serotonergic drugs or who have had considerable exposure to a single serotonin-augmenting drug. Diagnosis is made using the Hunter Serotonin Toxicity Criteria, which require the presence of one of ...
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Abstract An 18-year-old male developed a severe serotonin syndrome after recreational ingestion of Coricidin HBP (chlorpheniramine 4 mg and dextromethorphan hydrobromide 30 mg). Propofol infusion rapidly normalized his agitation, neuromuscular hyperactivity, and autonomic instability. Confirmatory analysis demonstrated a dextromethorphan serum concentration of 930 ng/mL. Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug.
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