Management of Serotonin Syndrome
Identify and stop all serotoninergic medications
 • Avoid inadvertent Rx of serotoninergic meds (i.e. fentanyl, tramadol, etc.)
Supportive Care: goal to normalize vital signs
 • Supplemental O2. IV fluids for volume depletion
 • Benzodiazepines for agitation and mildly elevated HR/BP
Severe illness with VS instability:
 • Intubation. *dation. pralysis
 • Pressor support for hypotension
Cyproheptadine: 5-HT2A antagonist
 • Oral only!
 • Dosing: 12mg loading dose, then 2 mg q2h if symptoms continue

UCSD Internal Medicine @ucsdim

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