Serotonin Syndrome: Pathogenesis and Clinical Findings
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Serotonin Syndrome: Pathogenesis and Clinical Findings

Serotonin Syndrome: Variable combination of mental status changes, autonomic instability, and neuromuscular hyperactivity ranging from mild to life-threatening with an abrupt onset (within minutes to hours) after medication ingestion and most cases resolving within 24 hours of cessation of offending medication

Serotonergic Agents: SSRls, SNRls, MOAls, TCAs, atypical antidepressants, antibiotics, mood stabilizers (valporate, lithium), opioids, antiemetic agents, triptans, weight loss agents, drugs of abuse (e.g. cocaine, amphetamines)

 • Altered Mental Status - Anxiety, confusion, agitation, hypervigilance, pressured speech, delirium, coma

 • Autonomic Instability - Shivering, diaphoresis, fever, diarrhea, tachycardia, mydriasis, hypertension

 • Neuromuscular Hyperactivity - Hyperreflexia, muscle rigidity (esp. lower extremities), myoclonus, tremor, incoordination, trismus , opisthotonus, ocular clonus, seizures



The Hunter Serotonin Toxicity Criteria is used to make a clinical diagnosis - History of serotonergic agent taken within past 5 weeks + any of the following clinical features:

 - Spontaneous clonus

 - Inducible clonus and either agitation or diaphoresis

 - Ocular clonus and either agitation or diaphoresis

 - Tremor and hyperreflexia

 - Hypertonia, temperature > 38C, and either ocular clonus or inducible clonus



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The Calgary Guide to Understanding Disease
@TheCalgaryGuide
Account created for The Calgary Guide to Understanding Disease - Linking pathophysiology to clinical presentation - http://calgaryguide.ucalgary.ca/
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