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Results The patient was sent to the emergency department secondary to suspected serotonin syndrome. More than half of affected patients will present with symptoms within 6 hours of starting a medication, changing a dose, or an overdose, or within two hours of an addition of a serotonergic drug. Conclusions Although rare, physicians should be aware of and vigilant in monitoring for the possibility of serotonin syndrome even after a single dose of a tricyclic antidepressant inconjunction with a pain medication. [Extracted from the article]