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A 53-year-old woman with a long history of depression was admitted to the hospital because of agitation, insomnia, and tremors. She had been taking fluoxetine, lorazepam, and mirtazapine for several months. The doses of fluoxetine and mirtazapine had just been increased. Physical examination showed a confused patient with hyperhidrosis, hyperreflexia, and myoclonus but without focal neurologic de cits. Vital signs were blood pressure 105/60 mm Hg, heart rate 130 bpm, respirations 32/min,, body temperature 103.8°F (39.8°C). Qualitative plasma tests for alcohol, opioids, benzodiazepines, and tricyclic antidepressants were negative. An electrocardiogram indicated sinus tachycardia. A brain computed tomography scan was normal. Which of the following disorders most likely caused the patient’s signs and symptoms?

A. Selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome
B. Mirtazapine overdose
C. Serotonin syndrome
D. Brain glioblastoma
E. Benzodiazepine abstinence syndrome
F. Cerebral hemorrhage

SCIENCE
HEALTH SCIENCE
NURSING
NURSING MSN 571

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