Gastrointestinal symptoms as an autonomic manifestation in Serotonin syndrome

Background
Applications of the use of serotonin agents are increasing in daily practice because they are less toxic. However, it is still necessary to pay attention to the risk of mortality. The effect of using serotonin agents is serotonin syndrome (SS). Clinical manifestations of SS can vary, from an altered mental state to disorders of the neuro-muscular, and gastrointestinal tract. Gastrointestinal symptoms need to be identified immediately so that SS does not worsen and become severe.

Case report
A woman, 20 years old, came to the hospital with the chief complaint of nausea for approximately 4 h, accompanied by headache, shaking and stiff hands, and abdominal pain. She had just taken 21 pills of 25 mg sertraline 4 h earlier. Physical examination revealed normal blood pressure, tachycardia, and mild abdominal pain. But no tremor, clonus, or rigid extremities were found. Laboratory and radiological examinations were normal. An electrocardiogram (ECG) is regular sinus tachycardia.

Conclusion
Clinical manifestations of SS can alter the mental state, and also can occur in the neuro-muscular and gastrointestinal tract. If clinical manifestations are found in the gastrointestinal tract on the use of preparations that can increase blood serotonin levels, then the symptoms are considered to be moderate and must be treated immediately.