Serotonin Syndrome Masquerading as Alcohol Withdrawal: A Case Report.

IF 1.1 4区医学 Q3 SUBSTANCE ABUSE

Journal of Addictive Diseases Pub Date : 2025-08-31 DOI:10.1080/10550887.2025.2545649

Mirsol Choi, Xena Wang, Mohit Singh, Jeremy Weleff

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Abstract

Introduction: Alcohol withdrawal syndrome (AWS) and serotonin syndrome (SS) share several overlapping symptoms, complicating diagnosis in patients with alcohol use disorder (AUD) on serotonergic treatment.

Case presentation: We describe a 54-year-old male with a history of AUD and anxiety disorder who presented to a residential treatment center after patient report about 11 days of alcohol abstinence. Despite an initially mild withdrawal course, he developed worsening tremors, nausea, diarrhea, diaphoresis, muscle twitching, rigidity, and restlessness beyond the typical AWS timeframe. His medication regimen included multiple serotonergic agents. Neurological examination revealed hyperreflexia, clonus, and persistent hypertension, fulfilling the Hunter Serotonin Toxicity Criteria for SS. All serotonergic medications were discontinued and supportive care was initiated, leading to rapid symptom improvement and resolution.

Conclusions: Thorough evaluation of medication history and symptom timeline during clinical assessment is critical for differentiating AWS and SS. Clinicians are encouraged to remain vigilant for SS in patients with AUD on serotonergic agents to prevent adverse outcomes and potential mortality.

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5 -羟色胺综合征伪装成酒精戒断：一例报告。

酒精戒断综合征（AWS）和血清素综合征（SS）有几个重叠的症状，使酒精使用障碍（AUD）患者在血清素能治疗时的诊断复杂化。病例介绍：我们描述了一名54岁的男性，有AUD和焦虑症的病史，在患者报告戒酒11天后，他来到了一家住院治疗中心。尽管最初有轻微的停药过程，但他出现了恶化的震颤、恶心、腹泻、出汗、肌肉抽搐、僵硬和不安，超出了典型的AWS时间框架。他的治疗方案包括多种血清素能药物。神经学检查显示反射亢进、耳鸣和持续性高血压，符合亨特血清素毒性标准。所有血清素能药物均停止使用，并开始支持性治疗，导致症状迅速改善和消退。结论：在临床评估中，全面评估用药史和症状时间对于区分AWS和SS至关重要。鼓励临床医生对使用5 -羟色胺能药物的AUD患者的SS保持警惕，以防止不良后果和潜在的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Addictive Diseases SUBSTANCE ABUSE-

CiteScore

4.30

自引率

4.30%

发文量

期刊介绍： The Journal of Addictive Diseases is an essential, comprehensive resource covering the full range of addictions for today"s addiction professional. This in-depth, practical journal helps you stay on top of the vital issues and the clinical skills necessary to ensure effective practice. The latest research, treatments, and public policy issues in addiction medicine are presented in a fully integrated, multi-specialty perspective. Top researchers and respected leaders in addiction issues share their knowledge and insights to keep you up-to-date on the most important research and practical applications.