Serotonin syndrome (serotonin toxicity)


Serotonin syndrome (serotonin toxicity):

Serotonin syndrome or toxicity is known to be one type of life-threatening condition related with increased serotonergic activity in the central nervous system (CNS). It is otherwise known as serotonin toxicity.  Serotonin syndrome also seen with therapeutic medication use .It is also includes inadvertent interactions between drugs, and intentional self-poisoning.


Cause:  Serotonin syndrome can be caused by a large number of medications and street drugs when taken alone at high doses or in combination with other serotonergic drugs. Serotonin syndrome has been detected in all age groups, including newborns and the elderly.

Physical examination:  tachycardia and hypertension are the typical vital sign abnormalities, but in severe cases may develop hyperthermia and dramatic swings in pulse and blood pressure. Pertinent physical examination findings may include: Hyperthermia, Agitation, Inducible or spontaneous muscle clonus, Muscle rigidity.

Patients with critical condition may develop severe complications, including disseminated intravascular coagulation, rhabdomyolysis, metabolic acidosis, renal failure, myoglobinuria, and acute respiratory distress syndrome.


The management of serotonin syndrome:
Application of the following principles is central to management of acute serotonin syndrome:
Discontinuation of all serotonergic agents
Supportive care aimed at normalization of vital signs
Sedation with benzodiazepines
Administration of serotonin antagonists

In order to narrow the differential diagnosis and to monitor for potential complications, particularly in severely ill patients, the following studies may be necessary: Complete blood count, Creatine phosphokinase, Coagulation studies, Blood culture, Urinalysis and urine culture, Plain chest radiograph.

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