Possible serotonin syndrome associated with buspirone added to fluoxetine

OBJECTIVE: To report the development of a possible serotonin syndrome in a patient taking buspirone and fluoxetine. CASE SUMMARY: A 37-year-old white man taking fluoxetine 20 mg/d for generalized anxiety disorder developed confusion, diaphoresis, incoordination, diarrhea, and myoclonus after buspirone was added to the drug regimen. DISCUSSION: Serotonin syndrome is a potentially lethal condition of serotonin hyperstimulation, which may develop rapidly or over the course of several weeks. Symptoms of serotonin syndrome typically occur following additions or increases of serotonin-enhancing drugs. Although buspirone has variable effects on post- and presynaptic 5-HT1A receptors that may reduce the risk of serotonin syndrome when administered as a single agent, it may cause an adverse reaction when given with other serotonergic drugs. CONCLUSIONS: Symptoms consistent with serotonin syndrome may develop with the concurrent administration of buspirone and fluoxetine.

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