Two cases of mild serotonin toxicity via 5-hydroxytryptamine 1A receptor stimulation
A 64-year-old woman who experienced auditory hallucinations and insomnia, was treated with hypnotic benzodiazepines and perospirone (8 mg/day; ). Perospirone had been administered for 4 months. She had developed chronic renal failure, which had continued for several years, with high serum levels of creatinine and blood urea nitrogen (). She also experienced depressed mood, diminished interest, and anhedonia; therefore, she was treated with paroxetine (10 mg/day). Eighteen hours after paroxetine was added to her ongoing perospirone treatment, she exhibited finger tremors, sweating, coarse shivering, hyperactive knee jerks, vomiting, diarrhea, tachycardia, and psychomotor agitation. After administrating paroxetine with perospirone twice, both paroxetine and perospirone were discontinued. Her symptoms gradually disappeared over a period of approximately 1 week.