Massive sertraline overdose.

Selective serotonin reuptake inhibitor medications are considered relatively safe even in overdose. We report a massive overdose of sertraline with the highest serum sertraline concentration reported to date. Clinical features of this patient were confusion, agitation, myoclonus, hyperreflexia, fever, and creatine kinase elevation. This case may represent serotonin syndrome caused by sertraline overdose alone.