Tuesday 9 November 2010

MRCP revision battle 44.3: Serotonin syndrome

Serotonin syndrome is characterised by the triad of:


  • autonomic hyperactivity
    • hypertension
    • hyperthermia
    • tachycardia
    • mydriasis
  • neuromuscular abnormality
    • hyperreflexia
    • clonus
    • tremor
    • hypertonicity
  • mental state changes


Drugs associated with serotonin syndrome include:
  • lithium
  • carbamazepine
  • triptans
  • illegal drugs
    • LSD
    • cocaine
    • MDMA
  • antidepressants
    • MAOIs
    • SSRIs
    • St Johns Wort

Treatment:
  • remove cause
  • supportive treatment
  • cyproheptadine - a 5HT antagonist
  • chlorpromazine for hyperthermia and agitation

 Now for some postnatal depression...