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ALL / Pharmacology
Serotonin syndrome
Serotonin syndrome
Causes- monoamine oxidase inhibitors
- SSRIs
- St John's Wort, often taken over the counter for depression, can interact with SSRIs to cause serotonin syndrome
- tramadol may also interact with SSRIs
- ecstasy
- amphetamines
Features
- neuromuscular excitation
- hyperreflexia
- myoclonus
- rigidity
- autonomic nervous system excitation
- hyperthermia
- sweating
- altered mental state
- confusion
Management
- supportive including IV fluids
- benzodiazepines
- more severe cases are managed using serotonin antagonists such as cyproheptadine and chlorpromazine
Venn diagram showing contrasting serotonin syndrome with neuroleptic malignant syndrome. Note that both conditions can cause a raised creatine kinase (CK) but it tends to be more associated with NMS.
+PassMedicine Notes
Causes
- monoamine oxidase inhibitors
- SSRIs
- St John's Wort, often taken over the counter for depression, can interact with SSRIs to cause serotonin syndrome
- tramadol may also interact with SSRIs
- ecstasy
- amphetamines
- neuromuscular excitation
- hyperreflexia
- myoclonus
- rigidity
- autonomic nervous system excitation
- hyperthermia
- sweating
- altered mental state
- confusion
- supportive including IV fluids
- benzodiazepines
- more severe cases are managed using serotonin antagonists such as cyproheptadine and chlorpromazine
