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Serotonin syndrome triggered by a single dose of suboxone
Journal article   Peer reviewed

Serotonin syndrome triggered by a single dose of suboxone

Derek Isenberg, Stella C Wong and John A Curtis
The American journal of emergency medicine, v 26(7), pp 840.e3-840.e5
31 Aug 2008
DOI: https://doi.org/10.1016/j.ajem.2008.01.039
PMID: 18774063

Abstract

Acute coronary syndromes Antidepressants Drug dosages Drug therapy Intensive care Physicians Serotonin
Buprenorphine/naloxone is an oral medication that contains buprenorphine, an opiate agonist/antagonist, and naloxone, an opiate antagonist. Because of its mixed properties at the κ- and μ-opiate receptors, buprenorphine, in contrast to pure opioid agonists such as heroin, has a ceiling on its euphoric effects. There was no change in the patient's condition with any of these interventions. Because of the need to obtain a computed tomographic scan and a lumbar puncture, the decision was made, after discussion with the family, to electively intubate the patient. The patients in these reports developed the classic triad of autonomic instability, neuromuscular changes, and altered mental status. Because morphine analogues do not inhibit serotonin reuptake like opioids, other theories have been proposed to explain SS involving these drugs.

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