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

Research output: Chapter in Book/Report/Conference proceedingChapter

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 languageEnglish (US)
Title of host publicationChallenging Cases and Complication Management in Pain Medicine
PublisherSpringer International Publishing
Pages45-48
Number of pages4
ISBN (Electronic)9783319600727
ISBN (Print)9783319600703
DOIs
Publication statusPublished - Jan 1 2017

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wisler, B., & Benzon, H. T. (2017). A case of serotonin syndrome in a patient receiving epidural steroid injection for chronic low back pain. In Challenging Cases and Complication Management in Pain Medicine (pp. 45-48). Springer International Publishing. https://doi.org/10.1007/978-3-319-60072-7_9