Potentially life-threatening emergency
Serotonin syndrome
Alerts and Notices
Synopsis

Individuals in any age group can develop serotonin syndrome. Onset of symptoms is usually within 6 hours from the time the offending medication was ingested. Signs and symptoms of more severe cases usually include a combination of mental status changes, autonomic instability, and hyperreflexia or clonus.
Management includes immediate discontinuation of the serotonergic medication, addressing abnormal vital signs, administering serotonin antagonists, and sedation. The prognosis for recovery is very good with early administration of supportive care.
Codes
ICD10CM:G25.89 – Other specified extrapyramidal and movement disorders
SNOMEDCT:
371089000 – Serotonin syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Neuroleptic malignant syndrome
- Malignant hyperthermia
- Anticholinergic poisoning
- Sepsis
- Meningitis (bacterial, aseptic, fungal)
- Encephalitis
- Manic episode (see bipolar disorders)
- Catatonia
- Agitated delirium
- Seizure with post-ictal confusion
- Tetanus
- Thyroid storm
- Delirium tremens / alcohol withdrawal
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/10/2018
Last Updated:05/10/2018
Last Updated:05/10/2018