Pharmacology · Pathway 28
Serotonin Syndrome
Key points
- Serotonin syndrome: excess serotonin activity, usually from combining serotonergic drugs (SSRIs, MAOIs, triptans, tramadol, St John's Wort).
- Features: agitation/confusion · clonus (key sign) · hyperreflexia · sweating · diarrhoea · tremor · hyperthermia.
- Neuromuscular excitation distinguishes it from NMS (which has bradyreflexia and rigidity).
- Management: stop serotonergic drugs, supportive care; cyproheptadine (5-HT2 antagonist) in severe cases.
Decision points in this pathway
- Clonus/hyperreflexia present?
The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.