Rhabdomyolysis in a male adolescent associated with monotherapy of fluvoxamine

Eur J Hosp Pharm. 2023 Sep;30(5):302-304. doi: 10.1136/ejhpharm-2022-003533. Epub 2022 Dec 2.

Abstract

Rhabdomyolysis is a syndrome resulting from striated muscular breakdown, which may occur due to drug therapy with agents such as selective serotonin reuptake inhibitors (SSRIs). Although studies have shown that fluvoxamine can rarely cause myalgia, there are no reported cases of rhabdomyolysis due to fluvoxamine monotherapy. Here we describe a case of rhabdomyolysis due to fluvoxamine monotherapy for obsessive-compulsive disorder. The young adolescent developed pain in the extremities, and an increase in serum creatine kinase (CK) and myoglobin during fluvoxamine treatment. These adverse reactions were reversed immediately after the medicine was changed to another SSRI-sertraline. This is the first reported case of fluvoxamine-associated rhabdomyolysis. It is advisable to determine serum CK levels before starting fluvoxamine treatment, and then at regular intervals, to avoid the occurrence of severe acute kidney injury with possible life-threatening complications.

Keywords: CLINICAL MEDICINE; Case Reports; DRUG-RELATED SIDE EFFECTS AND ADVERSE REACTIONS; MENTAL HEALTH; PSYCHIATRY.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Fluvoxamine / adverse effects
  • Humans
  • Male
  • Obsessive-Compulsive Disorder* / chemically induced
  • Obsessive-Compulsive Disorder* / drug therapy
  • Rhabdomyolysis* / chemically induced
  • Rhabdomyolysis* / diagnosis
  • Rhabdomyolysis* / drug therapy
  • Sertraline / therapeutic use

Substances

  • Fluvoxamine
  • Sertraline