Which of the following general statements concerning serotonin syndrome is correct?

A. Altered mental status, autonomic dysfunction, and neuromuscular abnormalities characterize serotonin syndrome.
B. Serotonin syndrome may occur in the absence of drug therapy.
C. Serotonin syndrome occurs when there is a net depletion of brain serotonin.
D. Antifungal agents are the most common class of drugs known to produce serotonin syndrome.
E. Diagnosis of serotonin syndrome can be accomplished by obtaining serum concentrations of suspected medications.
 
 

• Answer A is correct.

• Patients with serotonin syndrome often demonstrate altered mental status, autonomic nervous system dysfunction, and neuromuscular abnormalities.

• Serotonin syndrome only occurs as a result of drug therapy.  Serotonin syndrome most commonly occurs when two or more serotonergic drugs are given together; however, the syndrome has also been reported with single drug exposure in both therapeutic doses and overdoses.

• Serotonin syndrome occurs when there is a net increase in brain serotonin.

• Antidepressants that affect serotonin neurotransmission are the most common class of drugs associated with the production of serotonin syndrome.  Of these drugs, monoamine oxidase inhibitors are most commonly associated with the more severe cases of serotonin syndrome.

• Diagnosis of serotonin syndrome is based upon clinical findings and the exclusion of other conditions.  No single diagnostic test for serotonin syndrome exists. Serotonin syndrome has been reported to occur while the serum concentrations of suspected drugs remained in the therapeutic range.

References:  1, 2, and 3

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