ArticleAnesthesia and pain medicine2025
Noticeable changes in diaphoresis severity following pain management medication adjustments in a complex regional pain syndrome patient.
Article in Anesthesia and pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSerotonin syndrome results from the use of serotonergic agents that elevate intrasynaptic serotonin level or excessively activate serotonin postsynaptic receptors. Common serotonergic agents used for pain management include opioids, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and tricyclic antidepressants. PURPOSE: A 24-year old woman diagnosed with complex regional pain syndrome underwent multidrug therapy for pain management over approximately five years. During this period, changes in diaphoresis severity were noted following adjustments to pain medications. The concurrent use of multiple serotonergic agents, exacerbation of diaphoresis after the addition or dose escalation of opioids, and resolution of symptoms upon discontinuation of duloxetine (Cymbalta®, Lily S.A.) strongly suggest the development of serotonin syndrome.
conclusionsDiagnosing serotonin syndrome without neuromuscular symptoms can be challenging. Careful monitoring of changes in symptoms and signs following medication use is essential in such cases.
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