Summary: <p>Medical Error Prevention<br> Understanding Serotonin Syndrome<br> Instructor: Dr. Dawn-Elise Snipes<br> Executive Director: AllCEUs Counselor Education<br> Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery</p> <p>CEU course can be found at <a href="https://www.allceus.com/member/cart/index/search?q=Medical+Error+Prevention">AllCEUs.com</a></p> <p>Objectives<br> ~ Define Serotonin Syndrome<br> ~ Explore the drug interactions that often cause serotonin syndrome<br> ~ Explore risk factors for serotonin syndrome<br> ~ Discuss why mental health clinicians need to know about serotonin syndrome<br> ~ Learn about treatment for serotonin syndrome<br> Understanding SOME of the Serotonin Receptors<br> Ways Serotonin is Increased<br> ~ Increase in serotonin synthesis<br> ~ L-Tryptophan (esp. supplementation)<br> ~ Reduction in serotonin breakdown<br> ~ MAOIs: Isocarboxazid (Marplan) and phenelzine (Nardil)<br> ~ Increase serotonin release<br> ~ Amphetamines (ADHD medication, MDMA)<br> ~ Anorectics (appetite suppressants (dexadrine))<br> ~ Anti-migraine medications such as triptans (Axert, Amerge, Imitrex), carbamazepine (Tegretol) and valproic acid (Depakene)<br> Ways Serotonin is Increased<br> ~ Stimulation of Post Synaptic Receptors<br> ~ Buspirone<br> ~ Lithium<br> ~ Pain medications such as opioid pain medications including codeine (Tylenol with codeine), fentanyl (Duragesic), hydrocodone meperidine (Demerol), oxycodone (Oxycontin, Percocet, Percodan) and tramadol (Ultram).</p> <p>Ways Serotonin is Increased<br> ~ Serotonin Reuptake Inhibitor<br> ~ SSRI Antidepressants (Paxil, Prozax, Zoloft)<br> ~ Ultram (SSRI + mu-receptor activation)<br> ~ Trazadone (SARI: Serotonin Agonist and Reuptake Inhibitor)<br> ~ Tricyclic Antidepressants (i.e. Elavil (amitriptyline), Tofranil (imipramine), and Pamelor (nortriptyline ))<br> ~ Serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants such as duloxetine (Cymbalta) and venlafaxine (Effexor)<br> ~ Bupropion (Wellbutrin, Zyban) antidepressant and tobacco-addiction medication. Norepinephrine-dopamine reuptake inhibitor (NDRI)</p> <p> </p> <p>Other Drugs That Act To Raise Serotonin<br> ~ Illicit drugs, including LSD, Ecstasy, cocaine and amphetamines<br> ~ Herbal supplements, including St. John's wort, ginseng and nutmeg, 5-HTP<br> ~ Over-the-counter cough and cold medications containing dextromethorphan (Delsym, Mucinex DM, others)<br> ~ Anti-nausea medications such as granisetron, metoclopramide (Reglan), droperidol (Inapsine) and ondansetron (Zofran)<br> ~ Linezolid (Zyvox), an antibiotic<br> ~ Ritonavir (Norvir), an anti-retroviral medication used to treat HIV/AIDS</p> <p>http://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/dxc-20305673<br> CAN Identify<br> ~ C = Cognitive changes including agitation, confusion, euphoria, insomnia, hypomania and hallucinations<br> ~ A= Autonomic changes including tachycardia, fever, arrhythmias, sweating, dilated pupils<br> ~ N= Neuromuscular changes including tremor, rigidity, incoordination, seizures</p> <p>Other Symptoms<br> ~ Confusion<br> ~ Agitation or restlessness<br> ~ Dilated pupils<br> ~ Headache<br> ~ Changes in blood pressure and/or temperature<br> ~ Nausea and/or vomiting<br> ~ Diarrhea<br> ~ Rapid heart rate<br> ~ Tremor<br> ~ Loss of muscle coordination or twitching muscles<br> ~ Shivering and goose bumps<br> ~ Heavy sweating</p> <p>Life Threatening Stage<br> ~ In severe cases, serotonin syndrome can be life threatening. If you experience any of these symptoms, you or someone with you should seek medical attention immediately:<br> ~ High fever<br> ~ Seizures<br> ~ Irregular heartbeat<br> ~ Unconsciousness</p> <p>Risk Factors<br> ~ There is an increased risk of serotonin syndrome if the person:<br> ~ Recently started taking or increased the dose of a medication kno</p>
