A case of serotonin syndrome in a patient receiving epidural steroid injection for chronic low back pain

Brad Wisler; Honorio T Benzon

doi:10.1007/978-3-319-60072-7_9

A case of serotonin syndrome in a patient receiving epidural steroid injection for chronic low back pain

Brad Wisler, Honorio T Benzon^*

^*Corresponding author for this work

Anesthesiology

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

Serotonin syndrome is usually seen in patients who are on serotonergic agents such as an SSRI and MAO inhibitor. Medications that affect serotonin metabolism and induce the syndrome include MAOIs, antidepressants, opioids, cough medicines, and illicit drugs. The mechanisms in its development include inhibition of reuptake of serotonin, enhanced presynaptic release, and MAO inhibition. The clinical triad includes mental status changes, autonomic hyperactivity, and neuromuscular abnormalities (myoclonus, hyperreflexia, rigidity). Diagnostic criteria include the Sternbach and the Hunter criteria. Treatments include supportive therapy and cyproheptadine, a benzodiazepine and 5-HT2A antagonist.

Original language	English (US)
Title of host publication	Challenging Cases and Complication Management in Pain Medicine
Publisher	Springer International Publishing
Pages	45-48
Number of pages	4
ISBN (Electronic)	9783319600727
ISBN (Print)	9783319600703
DOIs	https://doi.org/10.1007/978-3-319-60072-7_9
State	Published - Jan 1 2017

ASJC Scopus subject areas

Medicine(all)

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10.1007/978-3-319-60072-7_9

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AB - Serotonin syndrome is usually seen in patients who are on serotonergic agents such as an SSRI and MAO inhibitor. Medications that affect serotonin metabolism and induce the syndrome include MAOIs, antidepressants, opioids, cough medicines, and illicit drugs. The mechanisms in its development include inhibition of reuptake of serotonin, enhanced presynaptic release, and MAO inhibition. The clinical triad includes mental status changes, autonomic hyperactivity, and neuromuscular abnormalities (myoclonus, hyperreflexia, rigidity). Diagnostic criteria include the Sternbach and the Hunter criteria. Treatments include supportive therapy and cyproheptadine, a benzodiazepine and 5-HT2A antagonist.

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A case of serotonin syndrome in a patient receiving epidural steroid injection for chronic low back pain

Abstract

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