Abstract
This case report discusses the history and management of a schizophrenic patient, a 18-year-old man, who had taken a massive overdose of clonazepam, abilify, depakote, zoloft and seroquel altogether. After discontinuation of these drugs and administration of cyproheptadine with IV fluids, he became hemo-dynamically stable. This case suggests that serotonin syndrome should be recognized promptly and complications need to be treated appropriately. Serotonin syndrome should be diagnosed surely to ensure the prompt initiation of the treatment including discontinuation of the precipitating drugs because the disease occasionally progresses rapidly to fatal condition. In addition, both the onset and resolution of symptoms are faster in serotonin syndrome.
Highlights
Serotonin Reuptake Inhibitors (SSRI), TricyclicAntidepressants (TCA) and Monoamine OxidaseThe serotonin syndrome is the clinical demonstration Inhibitors (MAOI).of serotonin toxicity in patients taking one or moreDiagnosis is recognized on clinical presentation serotonergic agents
Management consists of termination by features of (1) mental status changes such as of the offending agent and supportive care, a confusion, agitation, lethargy and coma, (2) autonomic possible medication with serotonin antagonists, such instability such as hyperthermia, tachycardia, as cyproheptadine and benzodiazepine can aid in diaphoresis, nausea, vomiting, diarrhea and dilated validating the diagnosis and improve symptoms
The only characteristic that distinguished Neuroleptic Malignant Syndrome (NMS) from serotonin syndrome is the lead-pipe stiffness related with the previous syndrome distinguished with the clonus and hyperreflexia observed with serotonin syndrome
Summary
The serotonin syndrome is the clinical demonstration Inhibitors (MAOI). Diagnosis is recognized on clinical presentation serotonergic agents. The serotonin syndrome has a and exposure to serotonergic medications, though potentially severe effect caused by serious serotonergic other roots of mental changes characteristically need activity in the central nervous system. Pupils) and (3) neuromuscular hyperactivity such as Medication overdose can trigger serotonin syndrome myoclonus, hyperreflexia, rigidity and trismus This through a range of mechanisms: (1) Blockade of disease is a manifestation of an overload of serotonin serotonin reuptake; (2) inhibition of serotonin and include a range of clinical features ranging from metabolism; (3) increased production of serotonin and minor symptoms to death. Corresponding Author: Kelly Schrapp, Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA 30310-1495, Georgia Both analgesics, meperidine and tramadol, are serotonin receptor agonists. The authors are the first to report a shortened and less severe course of serotonin syndrome due to the patient overdosing with a benzodiazepine
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