ArticleNeurocritical care2014
Serotonin syndrome in the intensive care unit: clinical presentations and precipitating medications.
Article in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 79 citations in OpenAlex.
- Postoperative Serotonin Syndrome: A Case Report Highlighting Dexmedetomidine for Refractory Symptoms.Cureus · 2025Article
- Linezolid and serotonin syndrome.The Journal of international medical research · 2025Review
- Noticeable changes in diaphoresis severity following pain management medication adjustments in a complex regional pain syndrome patient.Anesthesia and pain medicine · 2025Article
- Serotonin syndrome controversies: A need for consensus.World journal of critical care medicine · 2024Review
- Recognizing serotonin syndrome in the intensive care unit: a case report of serotonin syndrome in a patient taking amitriptyline, buprenorphine, pregabalin, and fentanyl.AME case reports · 2024Article
- When Is Being Sad on the Burn Unit Pathological? Differential Diagnosis of Demoralization, Adjustment Disorder and Major Depressive Disorder in Burn Survivors.European burn journal · 2022Review
- Clinically Relevant Drug Interactions with Monoamine Oxidase Inhibitors.Health psychology research · 2022Article
- Coexistence of serotonin syndrome and neuroleptic malignant syndrome: does it exist?BMJ case reports · 2021Article
- Serotonin-Its Synthesis and Roles in the Healthy and the Critically Ill.International journal of molecular sciences · 2021Review
- Multimodal Analgesic Management for Cervical Spine Surgery in the Ambulatory Setting.International journal of spine surgery · 2021Article
- Interventions of a clinical pharmacist in a medical intensive care unit - A retrospective analysis.Bosnian journal of basic medical sciences · 2020Article
- Serotonin Syndrome in ICU-A Road Less Traveled.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Serotonin Syndrome in the Perioperative Setting.The American journal of case reports · 2018Article
- Psychotropic drug therapy in patients in the intensive care unit - usage, adverse effects, and drug interactions: a review.Therapeutics and clinical risk management · 2018Review
- Unsuspected serotonin toxicity in the ICU.Annals of intensive care · 2016Article
- Challenges in a large mixed drug overdose patient.BMJ case reports · 2016Article
- Neurologic Complications of Commonly Used Drugs in the Hospital Setting.Current neurology and neuroscience reports · 2016Review
- Effects of opioids on human serotonin transporters.Naunyn-Schmiedeberg's archives of pharmacology · 2015Article
- Changes in intensity of serotonin syndrome caused by adverse interaction between monoamine oxidase inhibitors and serotonin reuptake blockers.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2014Article
- Serotonin syndrome: An often-neglected medical emergency.Journal of family & community medicineReview
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerotonin syndrome (SS) is becoming a more frequent diagnosis in the intensive care unit (ICU). We sought to determine the clinical presentation, drug exposures, and outcomes of SS in critically ill patients.
methodsA retrospective study of 33 consecutive ICU patients with SS between March 2007 and March 2012 in ICUs in a large teaching hospital. SS was defined using the Hunter Serotonin Toxicity Criteria.
resultsSeventeen patients (52%) were admitted for mental status changes, including seven patients (21%) with drug overdose and four cases (12%) in which SS was considered the primary admission diagnosis. In 13 patients (39%) the features of SS developed only after a mean of 6.8 ± 9 days of hospitalization. Most received multiple serotonergic drugs upon diagnosis (median three drugs, range 1-5). Antidepressants were the serotonergic medications most often used before admission, and opioids (principally fentanyl) and antiemetics were the most frequently prescribed new serotonin-enhancing medications. Altered mental status was present in all patients and myoclonus, rigidity, and hyperreflexia were the most prevalent examination signs. All but one patient had documented recovery. The mean time to neurological improvement was 56 ± 5 h, but ranged from 8 to 288 h. There were no cases of renal failure related to rhabdomyolysis, or death or persistent disability caused by SS.
conclusionSS in the ICU occurs most often because of exposure to multiple serotonergic agents. Continuation of antidepressants plus the addition of opioids and antiemetics during hospitalization are most commonly responsible for this complication.
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