Abstract
74-year-old patient, diagnosed with recurrent major depressive disorder. The patient is under psychopharmacological treatment with lithium 600 mg / day, quetiapine 25 mg / day and venlafaxine 300 mg / day. After experiencing an exacerbation of her chronic low back pain, she was treated in the Emergency Room of her referral hospital with an intramuscular injection of tramadol. Within a few hours, the patient experiences a worsening of her general condition and a fluctuating level of consciousness which evolves towards a clinical picture of muscular rigidity, myoclonus, unintelligible speech and hyperthermia. The patient is diagnosed with serotonin syndrome. The serotonergic agents are discontinued and support treatment is started, with a clinical resolution around 24 hours later. This work aims to highlight the importance of making an early detection of this clinical picture and to make both medical profes- sionals and patients aware of the potential risks of drug interactions.
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