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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Diagnosis of serotonin syndrome

Diagnosis of serotonin syndrome

Patients on a stable dose of a serotonergic agent are unlikely to develop serotonin syndrome.

Based on Hunter Toxicity Criteria Decision Rules.

Refer to UpToDate content for further discussion on serotonin syndrome.

SSRIs: selective serotonin reuptake inhibitors; SNRIs: serotonin-norepinephrine reuptake inhibitors; MAO: monoamine oxidase; MDMA: 3,4-methylenedioxymethamphetamine (ie, ecstasy).

* Neuromuscular findings typically occur in lower extremities.

¶ Clonus should be greater than 3 beats.

Δ Ocular clonus is slow, continuous, horizontal bilateral eye movements occurring in an unresponsive patient.

◊ Examples of common direct serotonin receptor agonists:

  • Buspirone
  • Triptans (eg, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
  • Ergot derivatives (eg, dihydroergotamine, ergotamine, methylergonovine)
  • Fentanyl, other opioids
  • Lysergic acid diethylamide (LSD)
  • Metaxalone

§ SSRIs rarely cause severe serotonin toxicity while medications that inhibit MAO are more likely to cause severe serotonin syndrome.

Adapted from:
  1. Dunkley EJ, Isbister GK, Sibbritt D, et al. The Hunter Serotonin Toxicity Criteria: Simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003; 96:635.
  2. Chiew AL, Buckley NA. The serotonin toxidrome: Shortfalls of current diagnostic criteria for related syndromes. Clin Toxicol (Phila) 2022; 60:143.
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