Which of the following statements regarding the clinical manifestations of serotonin syndrome is correct?

A. Dry skin and mucous membranes are characteristic symptoms.
B. Hyperthermia associated with serotonin syndrome is partly due to autonomic nervous system dysfunction.
C. Symptoms commonly develop gradually, over several days to weeks.
D. Clinical improvement may not be seen for many days after simply discontinuing offending agent(s).
E. Serotonin syndrome has not been reported in children.
 
 

• Answer B is correct.

• Hyperthermia associated with serotonin syndrome is partly due to alterations in the thermoregulatory function of the autonomic nervous system.  Other factors such as muscle rigidity, shivering, and vasoconstriction also contributes to the development of hyperthermia in these patients.

• Autonomic nervous system dysfunction includes:

 
• Hyperthermia – temperature > 38.0 C (100.4 F)
• Sinus tachycardia
• Hypertension
• Tachypnea
• Diaphoresis

• Profuse diaphoresis is commonly reported with serotonin syndrome.

• Symptoms frequently begin within minutes to hours after administration of offending agent(s). Some patients may infrequently report recurrent mild symptoms, days to weeks before symptoms become more severe.

• Symptoms often improve within 24 hours after discontinuing the offending agent(s).

• Symptoms rarely last longer than 72 to 96 hours in the absence of complications.

• Serotonin syndrome has been reported to occur in both adults and children.

References: 1, 2, and 3

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