Serotonin Syndrome in an Adolescent as a Result of Suicide with Fluoxetine

The overdose of selective serotonin reuptake inhibitor rarely causes death or serious sequelae. While it may be mildlysymptomatic or asymptomatic at doses up to 30 times the daily therapeutic dose, higher doses may cause drowsiness, tremor,gastrointestinal distress, and serotonin syndrome. Serotonin syndrome is a life-threatening condition associated with increasedserotonergic activity in the central nervous system. We presented a case who used fluoxetine with the diagnosis of unipolar depressionand developed serotonin syndrome as a result of overdose for suicide.

 A 14-year-old female patient, who was followed up by psychiatry for unipolar depression, ingested 30 tablet fluoxetinefor a suicide attempt. Afterwards, serotonin syndrome was observed. As a result of cyproheptadine treatment for signs that developedduring the patient's follow-up in the pediatric emergency department, the symptoms started to regress at the 24th hour.

In the literature, no similar case study has pointed to a developed serotonin syndrome after suicide with fluoxetine inchildren. The present study discusses a case in which a side effect resulting in serotonin syndrome occurred after a suicide attemptwith fluoxetine.

Although it is stated that fluoxetine overdose is benign, pediatric emergency physicians should be aware that serotoninsyndrome may develop in suicidal, high-dose fluoxetine intakes.