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A 51-year-old woman developed serotonin syndrome after initiating ciprofloxacin for a urinary tract complaint while receiving duloxetine for panic disorder [routes not stated].
The woman presented with irritability, restlessness, headache, dizziness, heart palpitations, tension, hot flushes, nausea, diarrhoea and dry mouth; she also reported hyperhidrosis, shivering, tremor, blurred vision and gait disturbance. She appeared anxious and restless on presentation. One year prior, she had been diagnosed with panic disorder and duloxetine 60 mg/day was initiated. Ciprofloxacin 1500 mg/day, 750mg 2 x 1, was started 2 days prior...