Journal of Nursing : Serotonin Toxicity
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Mystery Diagnosis: Recognizing Serotonin Syndrome
Wendy Blatchley
Serotonin syndrome (SS) is a rare condition that is believed to be induced by ingestion of serotonergic medications, leading to an increased serotonin level. Although many medications are thought to be responsible, some of the more common are antidepressants and opioids. There are no definitive tests to confirm SS, therefore diagnosis is based on clinical findings and can be somewhat difficult. A triad of symptoms, neuromuscular hyperactivity, altered mental status, and autonomic hyperactivity, are considered the hallmark signs, but are not present in all cases. Symptoms can vary from mild and almost undetectable to severe and life threatening. Three diagnostic systems are currently utilized to assist with diagnosis if SS is suspected: the Hunter, Sternbach, and Radomski criteria. A diagnosis of SS should prompt discontinuation of the suspected offending agent. Increased awareness of this issue is needed, including symptoms and risk factors, so that the advanced practice registered nurse (APRN) may promptly recognize and diagnosis this condition to avoid further complications. Completing a thorough history and physical, along with accurate medication reconciliation can assist the APRN in identifying high risk patients. While there is still so much about SS that remains unknown, current information and education on this issue will ensure the APRN is providing safe and high-quality care. Databases utilized were CINAHL, PubMed, and ScienceDirect. These databases provide access to numerous nursing, biomedical, and scientific journals and were useful in locating up-to-date, peer reviewed research on this subject.
