UMMS Affiliation

Department of Medicine, Division of General Internal Medicine; Meyers Primary Care Institute

Publication Date


Document Type



Chemicals and Drugs | Internal Medicine | Medical Pharmacology | Medical Toxicology


Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. It is classically associated with the simultaneous administration of two serotonergic agents, but it can occur after initiation of a single serotonergic drug or increasing the dose of a serotonergic drug in individuals who are particularly sensitive to serotonin. We describe a case of serotonin syndrome that occurred after ingestion of higher than prescribed doses of lamotrigine and aripiprazole, in addition to cocaine abuse. The diagnosis was established based on Hunter toxicity criteria and severity was classified as mild. The features of this syndrome resolved shortly after discontinuation of the offending agents. Serotonin syndrome is characterized by mental status changes, autonomic hyperactivity, and neuromuscular abnormalities along a spectrum ranging from mild to severe. Serotonin syndrome in our patient was most likely caused by the pharmacokinetic and pharmacodynamic interactions between lamotrigine, aripiprazole, and cocaine leading to increased CNS serotonergic activity.

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Copyright © 2015 Anupam Kotwal and Sarah L. Cutrona. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

DOI of Published Version



Anupam Kotwal and Sarah L. Cutrona, “Serotonin Syndrome in the Setting of Lamotrigine, Aripiprazole, and Cocaine Use,” Case Reports in Medicine, vol. 2015, Article ID 769531, 3 pages, 2015. doi:10.1155/2015/769531. Link to article on publisher's site

Journal/Book/Conference Title

Case Reports in Medicine

Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.