Tasty Morsels of EM 036 – Serotonin Syndrome

I keep a little, ever-expanding note on my phone where I jot down little morsels of goodness that I pick up while listening to or reading one of the many excellent sites/podcasts in the useful resource section. They’re useful in a kind of “board review” way. I tend to skip the really basic stuff and try and focus on what I didn’t know.

I’ll try and transfer them here for your enlightenment.

  • ‘CAN’

    • C: Cental Nervous Syndrome

      • Altered Mental State

      • Seizures

    • A: Autonomic Nervous System

      • BP High or Low

      • HR High or Low

      • Mydriasis

      • Flushing, sweating

      • Hyperthermia

    • N: Neuromuscular dysfunction

      • Rigidity

      • Hyperreflexia

      • Clonus, inc ocular) If spontaneous then highly suspicious

      • Tremor

  • Comes from

    • serotonergic drugs, in OD or combination

  • Treat with

    • the usual (and probably the most important) supportive care

    • cyproheptadine (anti-histamine and anti-serotonergic) the one to remember

References:

  • Serotonin Syndrome NEJM [via Salim Rezaie]
  • Critical Care Compendium LITFL and Conundrum

Featured Image: Wikimedia Commons

About Andy Neill

EM Reg/Resident based near Dublin. Former anatomy lecturer, theology student and occasional musician @andyneill | + Andy Neill | Contact

Speak Your Mind

*