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Case Reports
. 2024 Apr 16;17(4):e260229.
doi: 10.1136/bcr-2024-260229.

Serotonin syndrome presenting as acute dizziness with supine hypertension and orthostatic hypotension

Affiliations
Case Reports

Serotonin syndrome presenting as acute dizziness with supine hypertension and orthostatic hypotension

Sanjay Prakash et al. BMJ Case Rep. .

Abstract

Serotonin syndrome (SS) is a drug-induced clinical syndrome characterised by a combination of cognitive, neuromuscular and autonomic dysfunctions. The symptoms may include mild non-specific symptoms such as tremors and diarrhoea to coma and sudden death. Herein, we describe a case of SS in which acute dizziness was associated with supine hypertension and orthostatic hypotension. A man in his mid-30s had a 10-month history of anxiety, depression and chronic tension-type headache. He had been on amitriptyline (25 mg daily) and sertraline (50 mg daily). Increment of sertraline (75 mg daily) and amitriptyline (75 mg daily) and the addition of tramadol led to the development of acute severe dizziness. Physical examinations demonstrate supine hypertension and orthostatic hypotension. He also met the diagnostic criteria of SS. The administration of cyproheptadine provided a complete response to dizziness, supine hypertension, orthostatic hypotension and other clinical features of SS.

Keywords: Drugs: psychiatry; Neurology (drugs and medicines).

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Conflict of interest statement

Competing interests: None declared.

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