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