Management of Serotonin Syndrome Identify and stop all serotoninergic medications • Avoid inadvertent Rx of serotoninergic meds (i.e. fentanyl, tramadol, etc.) Supportive Care: goal to normalize vital signs • Supplemental O2. IV fluids for volume depletion • Benzodiazepines for agitation and mildly elevated HR/BP Severe illness with VS instability: • Intubation. *dation. pralysis • Pressor support for hypotension Cyproheptadine: 5-HT2A antagonist • Oral only! • Dosing: 12mg loading dose, then 2 mg q2h if symptoms continue UCSD Internal Medicine @ucsdim #Serotonin #Syndrome #Management #treatment #toxicology
