Management of patients with Serotonin syndrome

Serotonin is a chemical produced by the body, Serotonin allows brain cells as well as other cells of the nervous system to exchange information with each other. If there is less serotonin in the brain, it can be a factor in depression. In cases where too much Serotonin can cause excessive nerve cell activity and lead to potentially fatal symptoms, this is known as Serotonin syndrome.
The main cause of Serotonin syndrome is an overdose of drugs or a combination of drugs at the same time (eg, antidepressant combined with Triptan group...) will cause an increase in Serotonin levels. in the body.

When you have Serotonin syndrome, you will feel agitated or restless, confused or have a headache. In addition, other signs of Serotonin syndrome may include: Dilated pupils, nausea, and vomiting Changes in blood pressure or temperature, rapid heart rate, heavy sweating Diarrhea, shaking, floating goosebumps Muscle loss of coordination, muscle convulsions In some severe cases, Serotonin syndrome can be life-threatening, so if you experience the following dangerous signs of Serotonin syndrome, you should seek immediate medical attention. Get immediate help:
High fever, convulsions Heart arrhythmia Unconscious

The management of Serotonin syndrome depends on the extent of the disease. Specifically as follows:
If the disease has mild symptoms, just stop the drugs that cause Serotonin syndrome, and monitor the condition of the disease. After 24 hours the symptoms subsided. In case of gastrointestinal poisoning before 6 hours, gastric lavage, activated charcoal should be given to remove drugs that are the cause of Serotonin syndrome. If respiratory failure is severe, it is necessary to combine antipyretic treatment, adequate fluid resuscitation, sedative drugs to slow the heart rate, lower blood pressure, oxygen ...

Medications for Serotonin Syndrome include:
Benzodiazepines, a class of drugs used to treat Serotonin syndrome to help control agitation, seizures, or muscle stiffness. Cyproheptadin (Periactin) to block extra Serotonin production. When the patient is dehydrated and feverish, intravenous fluids and electrolytes should be infused. Medicines to control heart rate and blood pressure such as: Esmolol (Brevibloc) or Nitroprusside (Nitropress) if your heart rate is fast and blood pressure is high; Phenylephrine or Epinephrine when the patient has a slow heart rate and very low blood pressure. Serotonin syndrome is common and can be life-threatening, but it can be prevented if you pay attention to the side effects of medications that can cause this syndrome. Prevention methods include:
Avoid self-administering or increasing the dose of drugs that affect Serotonin levels in the body. When combined with a newly prescribed drug and that drug has a risk of causing Serotonin syndrome, the patient must consult a doctor for appropriate indications. In case of mild Serotonin syndrome, the patient needs to stop using the drug and then go to a medical facility to have an appropriate treatment.

Using drugs exactly as prescribed and safely is an effective way to prevent serotonin syndrome, so each person needs to be aware of the use of drugs according to the doctor's instructions, do not arbitrarily buy drugs for treatment and result in poor results. fit them together. If you are worried about how to use medicine properly, you can go to the Pharmacy Department - Vinmec International General Hospital with a system of modern facilities, medical equipment, and the same team. With a team of experts, doctors and pharmacists with many years of experience in medical examination, consultation and treatment, patients can rest assured when listening to advice on drug use at the Hospital. In case the patient has serotonin syndrome, they will be examined, consulted and carried out tests and imaging tests to assess the disease condition for timely and effective treatment. With a system of modern machinery and a team of highly qualified and experienced doctors, Vinmec is committed to the best protection for the health of patients.