Serotonin toxicity syndrome

Triad of:

  • neuromuscular hyperactivity (hyper-reflexia, clonus) – can be inducible, ocular or spontaneous,
  • autonomic instability (diaphoresis=sweating),
  • hyperpyrexia. 

Cool IV fluids, ice packs, bear hugger on cool, etc.

Benzodiazepines, PO/NG cyproheptadine.


No role for antipyretics! No evidence for dantrolene. Avoid suxamethonium, fentanyl, alfentanil. 

GG&C guideline

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