Abstract

Objective: Serotonin syndrome is a severe, often life threatening adverse drug reaction, resulting from excessive serotonin involving the peripheral and central nervous system. This frequently manifests with autonomic, neurocognitive and behavioral/somatic symptoms. This case study describes the neuropsychological consequences of a 42-year-old, Caucasian, right-handed female physician who was eventually diagnosed with serotonin syndrome in July 2011. Method: DR's initial symptoms began as inattention, mood swings, hyperactivity and extrapyramidal involvement. She required acute hospitalization and titration of selective serotonin reuptake inhibitors (SSRI). This combination of symptoms precluded her from practicing as a primary care physician. At 2 years post diagnosis, she was referred for neuropsychological consultation. Results: DR's neuropsychological test results suggested ongoing, albeit mild cognitive impairments as noted by scores on standardized neuropsychological indices (Halstead Impairment Index 0.4, GNDS 26). Primary deficits were in processing speed, working memory, bilateral sensorimotor functions, and behavioral concomitants. Conclusion(s): This case study underscores the importance of establishing neuropsychological data in individuals diagnosed with serotonin syndrome to assist in developing treatment recommendations with empahsis toward vocational reintegration.