q100 - ebnalfady

[ArchivalUser]

A 31-year-old female has been treated with fluoxetine for two months with no improvement in her depression. You decide to switch antidepressant therapy to phenelzine and instruct her to wait one week after stopping fluoxetine to start taking the new pills. She begins therapy immediately with phenyline without discontinuing fluoxetine. Two days later, she is brought to the ED with unstable vital signs, muscle rigidity, myoclonus, and hyperthermia. What caused these findings?
A.
Increased serotonin (5-HT) in synapses
B.
Increased norepinephrine in synapses
C.
Increased acetylcholine in synapses
D.
Increased dopamine in synapses

[ArchivalUser]

aa

[ArchivalUser]

AA......

[ArchivalUser]

aa

[ArchivalUser]

aa serotonin syndrome

[ArchivalUser]

The answer is: A

This patient has the serotonin syndrome. Serotonin is already present in increased amounts in synapses because of blockade of its reuptake by the SSRIs. The amount of serotonin that is present is further increased when breakdown by MAO is inhibited. The serotonin syndrome can be life threatening.