Please note: This is the pharmacology version of the course: Serotonin Syndrome [Poisoning]: Criteria for a Timely Diagnosis and Treatment R552.ย Click here to take the general version (no pharmacology CEs).

Course Summary

Expiration Date: 06/03/2028

Serotonin syndrome, also termed serotonin poisoning, is a diagnosis of exclusion, and it can be mistaken for an infectious or a metabolic disorder, substance withdrawal, or, more likely, other drug-induced syndromes. The treatment of serotonin poisoning is symptomatic and supportive. Serotonergic drugs are widely used, and intentional overdoses with serotonergic drugs are not uncommon. Serotonin poisoning is a condition caused by an abnormal increase in central nervous system serotonin concentration and/or excessive serotonergic activity. Serotonin poisoning can be an adverse drug effect, a drug-drug reaction, a drug-food reaction, or it can be caused by an overdose of serotonergic drugs. The clinical presentation can be mild and self-limiting, but can develop to a potentially lethal condition. Determining which drugs may be causing serotonin poisoning can be difficult and depend on clinician knowledge and practice, including analytical, objective methods to confirm the diagnosis. Many clinicians are unaware of the criteria for diagnosing serotonin poisoning, and need to be educated on the use of a reliable drug database to check for drug-drug interactions when they are prescribing drugs that can affect serotonin activity and blood levels.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • The Serotonin System and Risk of Serotonin Poisoning
    • The Serotonergic System
    • Serotonin Poisoning
  • Pathophysiology of Serotonin Syndrome
    • Drug-Induced Serotonin Poisoning
    • Clinical Presentation
  • Diagnosis of a Serotonin Poisoning Event
    • Physical and History
    • MAOIs
    • Anticholinergic Syndrome versus Serotonin Poisoning
    • Neuroleptic Malignant Syndrome versus Serotonin Poisoning
    • Sympathomimetic Syndrome versus Serotonin Poisoning
    • Diagnostic Criteria: Three Clinical Tools
    • Pregnancy and Breastfeeding
  • Treatment of Serotonin Discontinuation Syndrome
    • 5-HT Receptor Antagonists
    • Other Pharmacologic Treatment
  • Case Study: Medication Error Leading to Serotonin Syndrome
  • Summary

Author

Dana Bartlett, RN, BSN, MSN, MA, CSPI

Dana Bartlett is a professional nurse and author. His clinical experience includes 16 years of ICU and ER experience and over 27 years as a poison control center information specialist. Dana has published numerous CE and journal articles, written NCLEX material, textbook chapters, and more than 100 online CE articles, and done editing and reviewing for publishers such as Elsevier, Lippincott, and Thieme. He has written widely on the subject of toxicology and was a contributing editor, toxicology section, for Critical Care Nurse journal. He is currently employed at the Connecticut Poison Control Center. He lives in Wappingers Falls, NY.