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Serotonin syndrome associated with methadone and milk thistle seeds: a case report
CELOFIGA, ANDREJA; HLADEN, TOMO BRUS.
  • CELOFIGA, ANDREJA; University Medical Centre Maribor. Department of Psychiatry. SI
  • HLADEN, TOMO BRUS; University Medical Centre Maribor. Department of Psychiatry. SI
Arch. Clin. Psychiatry (Impr.) ; 47(3): 85-86, May-June 2020.
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1130984
ABSTRACT
Abstract Background Serotonin syndrome is rarely, potentially life threatening condition, associated with use of serotonin acting medications and psychoactive drugs. In the majority of cases the symptoms occur soon after the initiation of a new drug or a change in the dose. Objective To present a case report and to describe the possible mechanism of development of serotonin syndrome during the interactions between milk thistle seeds and methadone on hepatic cytochrome enzyme system P450. Methods A case report of a young man on regular therapy with methadone, who develop a serotonin syndrome after ingestion a high dose of milk thistle seeds. Results Commercial preparations of milk thistle include the extract silibinin, which exhibits no beneficial or harmful drug interactions at normal doses, but at higher concentrations it can lead to dose-dependent effects on methadone metabolism, through inhibition of CYP3A4 and P-glycoprotein. As a result, it may lead to enhanced serotonin re-uptake inhibition and increased serotonin activity. Discussion Milk thistle is widely used and recommended for detoxification, but it may have serious and life threatening interactions with psychotropic drugs and psychoactive substances when used in high doses.


Texto completo: Disponible Índice: LILACS (Américas) Tipo de estudio: Factores de riesgo Idioma: Inglés Revista: Arch. Clin. Psychiatry (Impr.) Asunto de la revista: Psiquiatria Año: 2020 Tipo del documento: Artículo País de afiliación: Eslovenia Institución/País de afiliación: University Medical Centre Maribor/SI

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Texto completo: Disponible Índice: LILACS (Américas) Tipo de estudio: Factores de riesgo Idioma: Inglés Revista: Arch. Clin. Psychiatry (Impr.) Asunto de la revista: Psiquiatria Año: 2020 Tipo del documento: Artículo País de afiliación: Eslovenia Institución/País de afiliación: University Medical Centre Maribor/SI