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Serotonin Syndrome (DRUG-INDUCED), Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Constellation of signs and symptoms from excessive stimulation of central and peripheral serotonergic receptors

  • Spectrum of symptoms may range from mild and subtle findings to severe ...

Diagnosis

Signs and Symptoms

History

  • May be difficult to obtain:

    • Family, friends, EMS personnel, may provide additional information

  • Patient medication list: Prescribed medications, over-the-counter medica...

Treatment

Pre-Hospital

  • Stabilize airway

  • Vital signs

  • IV access

  • Fingerstick glucose

  • Oxygen administration if needed

Initial Stabilization/Therapy

  • Stabilize airway, establish IV access, continuous cardiac and t...

Follow-Up

Disposition

Admission Criteria

  • All patients suspected to have serotonin toxicity, even mild-appearing cases, should be admitted for monitoring and treatment

  • Severe symptoms including uncontroll...

Pearls and Pitfalls

  • Serotonin syndrome may be mild to severe in presentation; diagnosis in mild cases often elusive/missed

  • Mental status changes, hyperthermia, muscular clonus in lower extremities are ...

Additional Reading

  • Ables  AZ, Nagubilli  R. Prevention, recognition, and management of serotonin syndrome. Am Fam Physician.  2010;81:1139–1142.

  • Boyer  EW, Shannon  M. The Serotonin syndrome. N En...

Codes

ICD9

333.99 Other extrapyramidal diseases and abnormal movement disorders 

ICD10

G25.89 Other specified extrapyramidal and movement disorders 

SNOMED

  • 371089000 Serotonin syndrome (disorder)

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