Serotonin Syndrome

Serotonin syndrome
Serotonergic med plus 1of the 5 : 1. Clonus 2. Clonus + agitation + diaphoresis 3. Tremors + Hyperreflexia 4. Ocular Clonus + diaphoresis + agitation 5. Hypertonia + hyperthermia + clonus Ref: Up-to-date

🔴 Serotonin Syndrome👉🏿 Potentially life-threatening ◾️Any drug which ↑serotonin: ▪️SSRIs, MAO inhibitors,  SNRis, TCAs. amphetamines, Ectasy, Cocaine, Tramadol, Mirtazapine, Pentazocine, Dextromethorphan, All  SSRIs, SNRIs, Bupropion, Trazodone, cyclic antidepressants, methylphenidate, 5HT3 receptor antagonist Ondansetron(Zofran) +, cyclobenzaprine, Buspirone, Triptans, Fentanyl, Metaxalon (Skelaxin), LSD, Lithium, Methylphenidate etc. 🔘Mental status changes • Anxiety, delirium, restlessness, disorientation 🔘Autonomic hyperactivity • Diaphoresis,  tachycardia,  hyperthermia, agitation, restlessness, Pupils dilated, dry mucosa, flushed, 🔘 Neuromuscular abnormalities • Tremor,  clonus, hyperreflexia, bil up going toes, hypertonia 🔘HTN, hyperthermia, rapid changes in vital signs : pulse / blood pressureDx Diagnosis clinical but  chest x-ray, head CT, +/- lumbar puncture +/-plus regular labs, may be helpful👨⚕️Benzo : Ativan , Cyproheptidine (if benzo fails)🚦 if temperature >  105.8 F immediate sedation, paralyse, intubate,  rx hyperthermia⁉️ call the poison control

Serotonergic med plus at least 1 out of the 5 

1. Clonus

2. Clonus + agitation + diaphoresis

3. Tremors + Hyperreflexia

4. Ocular Clonus + diaphoresis + agitation 

5. Hypertonia + hyperthermia + clonus

ref: Up To date for the reading.



Not a medical advice. Read UpToDate. Correct. Improve. Share your knowledge w the students of medicine. 

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