Psychiatry

Question 1

What are the features of serotonin syndrome?

Answer 1

TRIAD of:

1. MENTAL STATUS CHANGE
   - Agitation
   - Confusion
   - Coma
2. NEUROMUSCULAR HYPERACTIVITY
   - Hyperreflexia
   - Hypertonic
   - Clonus
   - Tremor
3. AUTONOMIC DYSFUNCTION
   - Hypertension
   - Tachycardia
   - Fever/ hyperthermia
   - Diaphoresis
   - Pupil dilation
   - Flushing
   - N&V, diarrhoea

• Nearly always occurs within 24 hours of exposure to drugs that increase serotonin

Question 2

What are the features of an anticholinergic toxidrome?

Answer 2

Mydriasis (blind as a bat)
Dry mucous membranes (dry as a bone)
Flushed (red as a beet)
Altered mental status - esp. agitated delirium (mad as a hatter)
Hyperthermia (hot as hades)

+
Constipation
Urinary retention
Tachycardia