Serotonin syndrome masked by fibromyalgia: a case report

Author(s): Ference T, Schnitzer O, Feldman M, Fertig R, Klein J

Fibromyalgia is a disorder characterized by widespread myalgia, fatigue, and hyperesthesia. It also may present with mood fluctuation, insomnia, and memory issues. It has 1.75% prevalence in the US, affecting approximately 3.94 million persons. Although the full pathophysiology is still unknown, it is widely believed to be secondary to a lower pain threshold in the central nervous system, termed “central sensitization”. This hyperactivity can be attenuated by activating the pain modulatory circuit of the CNS3. Selective Serotonin Reuptake Inhibitors (SSRIs) are most likely active in this circuit, and have proven efficacy as adjunct therapy in management of pain due to fibromyalgia. This effect is independent of its antidepressant activity, so use of these drugs is not limited to patients with fibromyalgia and depression.