Title: Serotonin Syndrome (Part 1) - What is It? <br/>Author: Wan-Tsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><p>
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        <strong>Serotonin Syndrome - What is It?</strong></p>
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                Potentially life-threatening condition associated with increased serotonergic activity in the CNS.</li>
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                Selective serotonin reuptake inhibitors (SSRIs) are the most commonly implicated class of medications.  However, other medications can also be involved.</li>
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                <strong>It is a clinical diagnosis!</strong></li>
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                <u>Classic triad</u>: mental status change, autonomic hyperactivity, and neuromuscular abnormalities
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                                <u>Mental status change</u> - anxiety, agitation, restlessness, disorientation</li>
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                                <u>Autonomic hyperactivity</u> - diaphoresis, tachycardia, hypertension, hyperthermia, nausea, vomiting, diarrhea</li>
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                                <u>Neuromuscular abnormalities</u> - tremor, muscle rigidity, myoclonus, hyperreflexia, clonus, Babinski sign (abnormal plantar reflex)</li>
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                Hunter Criteria is the most accurate diagnostic rule:
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                                Serotonergic agent + one of the following:
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                                                Spontaneous clonus</li>
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                                                Inducible clonus <em>+</em> agitation or diaphoresis</li>
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                                                Ocular clonus <em>+</em> agitation or diaphoresis</li>
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                                                Tremor <i>+</i> hyperreflexia</li>
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                                                Hypertonia + temperature above 38C + ocular clonus or inducible clonus</li>
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                Majority of cases present within 24 hours, most within 6 hours, of a change in dose or initiation of a medication.</li>
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        <em>** Stay tuned for part 2 on what causes serotonin syndrome **</em></p>
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<fieldset><legend>References</legend>

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                Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352:1112-1120.</li>
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                Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96(9):635.</li>
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        <strong>Follow me on Twitter @EM_NCC</strong></p>
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