Serotonin syndrome

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Serotonin syndrome

Psychological disorders

Mood disorders

Major depressive disorder

Suicide

Bipolar disorder

Seasonal affective disorder

Premenstrual dysphoric disorder

Anxiety disorders

Generalized anxiety disorder

Social anxiety disorder

Panic disorder

Agoraphobia

Phobias

Obsessive-compulsive disorders

Obsessive-compulsive disorder

Body focused repetitive disorders

Body dysmorphic disorder

Stress-related disorders and abuse

Post-traumatic stress disorder

Physical and sexual abuse

Psychotic disorders

Schizoaffective disorder

Schizophreniform disorder

Delusional disorder

Schizophrenia

Cognitive and dissociative disorders

Delirium

Amnesia

Dissociative disorders

Eating disorders

Anorexia nervosa

Bulimia nervosa

Personality disorders

Cluster A personality disorders

Cluster B personality disorders

Cluster C personality disorders

Somatoform and factitious disorders

Somatic symptom disorder

Factitious disorder

Substance use disorders and drugs of abuse

Tobacco dependence

Opioid dependence

Cannabis dependence

Cocaine dependence

Alcohol use disorder

Sleep disorders

Bruxism

Nocturnal enuresis

Insomnia

Night terrors

Narcolepsy (NORD)

Sexual dysfunction disorders

Erectile dysfunction

Male hypoactive sexual desire disorder

Orgasmic dysfunction

Female sexual interest and arousal disorder

Genito-pelvic pain and penetration disorder

Pediatric disorders

Attention deficit hyperactivity disorder

Disruptive, impulse control, and conduct disorders

Learning disability

Fetal alcohol syndrome

Tourette syndrome

Autism spectrum disorder

Rett syndrome

Shaken baby syndrome

Enuresis

Encopresis

Psychiatric emergencies

Suicide

Serotonin syndrome

Neuroleptic malignant syndrome

Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review

Assessments

Serotonin syndrome

Flashcards

0 / 8 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

15 pages

Flashcards

Serotonin syndrome

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 55-year-old woman comes to the emergency department (ED) for evaluation of recurrent left flank pain and vomiting. She has a history of recurrent nephrolithiasis and recently noticed gross blood in her urine. Medical history is notable for obesity, hypertension, hyperlipidemia, depression, and type II diabetes mellitus. The patient has been taking ondansetron at home for nausea as well as losartan, metformin, rosuvastatin, and sertraline for her other medical conditions. On physical exam, the patient has left costovertebral angle tenderness. Blood is detected on urinalysis. The patient's symptoms are well controlled during the ED visit, and she is subsequently discharged with prescription analgesia, additional antiemetics, and urology follow-up. Three days later, the patient is brought back to the ED altered, diaphoretic, and agitated. Temperature is 39.4°C (103°F), pulse is 122/min, respirations are 20/min, and blood pressure is 184/95 mmHg. She has bilateral mydriasis and myoclonus. Which of the following medications was the most likely precipitant of this patient's clinical presentation?

External References

First Aid

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2016

Autonomic nervous system

in serotonin syndrome p. 592

Serotonin syndrome p. 409, 567, 573, 593

dextromethorphan p. 711

MAO inhibitors p. 599

MDMA p. 595

oxazolidinones p. 190

External Links

Summary

Serotonin syndrome is a potentially life-threatening condition that occurs when there is an excess of serotonin, a neurotransmitter in the brain, leading to a dangerous increase in nerve cell activity. Serotonin syndrome can occur as a result of taking certain medications, including selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) or taking a combination of medications that increase serotonin levels. Symptoms include agitation, confusion, muscle rigidity and hyperreflexia, hypertension, dysrhythmias, diaphoresis, and tachypnea. Treatment may include discontinuing the culprit drug, supportive management, and providing cyproheptadine.

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