#EMconf: Serotonin Syndrome

Serotonin Syndrome:

-Triad of alterations in cognitive, autonomic and neuromuscular function
-Mortality Rate = 2-12%
-Most cases occur at therapeutic drug doses
-Usually w/in 2-24 hrs of ↑ drug dose or addition of new serotonergic drug
-Often misinterpreted as other psych or medical syndrome


Birmes, P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003;168: 1439-42.

Greenier E, Lukyanova V, Reede L. Serotonin syndrome: fentanyl and selective serotonin reuptake inhibitor interactions. AANA Journal 2014;82: 340-345. 

LoVecchio F, Mattison E. Atypical and serotonergic antidepressants. In: Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e. New York, NY: McGraw-Hill; 2016.

Otter et al. Toxcard: differentiating serotonin syndrome from neuroleptic malignant syndrome. EMDocs 2017. 

Serotonin Syndrome. TUSOM Pharmwiki 2016. http://tmedweb.tulane.edu/pharmwiki/doku.php/serotonin_syndrome 

Stork CM. Serotonin reuptake inhibitors and atypical antidepressants. In: Goldfrank’s Toxicologic Emergencies. New York, NY: McGraw-Hill; 2006.

Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin Syndrome. The Ochsner Journal 2013;13: 533-540.