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Serotonin syndrome
  1. Stuart Maitland1,
  2. Mark Baker23
  1. 1 Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
  2. 2 Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
  3. 3 Department of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Dr Stuart Maitland, Clinical & Translational Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, Tyne and Wear, UK; Stu.Maitland{at}


The serotonin syndrome is a life-threatening adverse drug reaction resulting from excess serotonergic agonism due to interactions between multiple drugs, poisoning, or less commonly due to therapeutic action of a single drug. The central triad of features in serotonin syndrome are altered mental state, autonomic hyperactivity, and neuromuscular abnormalities in the context of a patient with new/altered serotonergic therapy, although not all these features are consistently present in all patients. The severity of serotonin syndrome can be assessed clinically based on the number and severity of features. Severe serotonin syndrome warrants more careful management on a high-dependency unit. In case of temperature exceeding 38.5°C, urgent cooling measures and sedation should be employed, progressing to rapid sequence intubation and paralysis if cooling measures are ineffective.

  • Drug interactions
  • Drug-Related Side Effects and Adverse Reactions

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

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