ICU SAQs · Toxicology
Serotonin syndrome — the recognition and the management
A CICM Second-Part SAQ on the serotonin syndrome — the recognition (the clonus, the hyperreflexia), the cyproheptadine, the benzodiazepine, the active cooling, the avoidance of the antipyretics and the suxamethonium.
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Prompt
A patient on an SSRI recently started on tramadol presents 12 hours later with agitation, a temperature of 39°C, inducible clonus and hyperreflexia. Outline the management.
Question
A patient on an SSRI recently started on tramadol presents 12 hours later with agitation, a temperature of 39°C, inducible clonus and hyperreflexia. Outline the management.
References3ShowHide
- [1]Mikkelsen N, Damkier P, Pedersen SA Serotonin syndrome - A focused review. Basic & Clinical Pharmacology & Toxicology, 2023.PMID 37309284
- [2]Chiew AL, Isbister GK Management of serotonin syndrome (toxicity). British Journal of Clinical Pharmacology, 2025.PMID 38926083
- [4]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.