Serotonin Syndrome assessment

A single 10-mg dose of rizatriptan was given to 12 healthy subjects after they took paroxetine 20 mg or a placebo daily for 14 days. The plasma levels of rizatriptan and its active metabolite were not altered by paroxetine, and no adverse effects were seen. Safety evaluations included blood pressure, heart rate, temperature and a visual analogue assessment of mood. There was no evidence of the serotonin syndrome. ... 

FIGURE 38-1. Primary assessment and initial treatment for complaint of excessive daytime sleepiness. RLS, restless-legs syndrome NPSG, nocturnal polysomnography OSA, obstructive sleep apnea DA, dopamine agonist MSLT, multiple sleep latency test BZDRA, benzodiazepine receptor agonist SNRI, serotonin and norepinephrine reuptake inhibitor TCA, tricyclic antidepressant CPAP, continuous positive airway pressure. 

Milnacipran is currently available for use as an antidepressant in several countries outside the U.S. It is also under clinical development to assess its potential role in the treatment of fibromyalgia syndrome [62,63]. In a rat model of neuropathic pain, milnacipran, administered intrathecally, produced dose-dependent anti-allodynic effects at doses between 3 and 100 gg for up to 7h [64], The anti-allodynic effect of 30 gg of milnacipran was attenuated by intrathecal coadministration of a serotonin receptor antagonist or a norepinephrine receptor... 

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