Clinical Relevance of Pharmacogenetics in Serotonin Syndrome

Serotonin syndrome is a predictable life-threatening condition that is caused by serotonergic stimulation of the central and peripheralnervous systems. A patient’s genetic profile can amplify exposure risk as many serotonergic drugs are metabolized by CYP450enzymes, and these enzymes may be altered in functionality. We report a case of an elderly man who presented with serotoninsyndrome after a dose change in valproic acid 5 weeks prior. His medication list consisted of low-dose serotonergic agents, whichis unusual as most cases of serotonin syndrome involve higher doses. A review of his pharmacogenetic profile is presented toretrospectively evaluate the additive risk for serotonin syndrome and implications on resuming serotonergic agents.