Mild serotonin syndrome: A report of 12 cases
| Autor: | Sanjay Prakash, Indravadan Patel, Siddharth Kakked, Rahul Yadav, Varsha P. Patel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Neurology clonus Short Communication Antidepressant Cyproheptadine Hyperreflexia Serotonergic Serotonin syndrome lcsh:RC346-429 selective serotonin reuptake inhibitors Medicine Outpatient clinic lcsh:Neurology. Diseases of the nervous system serotonin syndrome business.industry cyproheptadine tremor drug toxicity Clonus Anesthesia Hypertonia Neurology (clinical) medicine.symptom business medicine.drug |
| Zdroj: | Annals of Indian Academy of Neurology, Vol 18, Iss 2, Pp 226-230 (2015) Annals of Indian Academy of Neurology |
| ISSN: | 1998-3549 0972-2327 |
| Popis: | Serotonin syndrome (SS) is an under diagnosed and under reported condition. Mild SS is easily overlooked by physicians. Every patient with mild SS is a potential candidate for developing life-threatening severe SS because of inadvertent overdose or the addition of the second serotonergic drug. Herein, we describe 12 patients with mild SS observed over 12 months in neurology outpatient clinic. It is a retrospective chart review of 12 consecutive patients who had hyperreflexia with tremor (defined as mild SS Hunter's criteria) and had received serotonergic agents in the past 5 weeks. Only four patients (33%) reported tremor as a presenting or main feature. The presenting features in another eight patients were: Dizziness, generalized body pain, headache, and seizure. Five patients responded to the removal of the offending agents and got a complete response in 2-7 days. There were no or minimal responses in another seven patients to the removal of the serotonergic drugs. Cyproheptadine was started in these patients, at the dose of 8 mg three times daily. Response started within 1-3 days of initiation of the drug and the complete responses were noted in 5-14 days. There were no side effects from cyproheptadine in any patient. We suggest that any patient on serotonergic drug developing new symptoms should be examined for the presence of tremor, hypertonia, hyperreflexia, and clonus to look for mild SS. In addition, every patient on any serotonergic drug should be examined for the presence of mild SS before escalating the dose or before adding a new one. |
| Databáze: | OpenAIRE |
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