Anästhesie (Fach) / Krankheitsbilder (Lektion)

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Vorderseite Serotonerges Syndrom
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Symptome: excitation, hyperpyrexia, hypertension, profuse sweating, and rigidity. This may progress to seizures, coma, and death.

Auslösende Medikament:

  • Monoamine oxidase inhibitors (MAOIs)
  • Pethidine
  • Tricyclic antidepressants
  • Selective serotonin reuptake inhinitors (SSRIs)
  • Antibiotics (linezolid)
  • Opiates (meperidine, fentanyl, pentazocine)
  • Tramadol
  • Antiemetic agents (ondansetron, granisetron, metoclopromide)
  • Over-the-counter cough medications (dextromethorphan)
  • Lithium
  • Antimigraine drugs (sumatriptan)
  • Drugs of abuse (methylenedioxymethamphetamine or "ecstasy").
Differenzialdiagnose: neuroleptic malignant syndrome.
This is an idiopathic reaction to dopamine antagonists, a condition that is defined by:

  • A slow onset
  • Bradykinesia or akinesia
  • "Lead pipe" muscular rigidity
  • Hyperthermia
  • Fluctuating consciousness
  • Autonomic instability.

Signs and symptoms of the neuroleptic malignant syndrome typically evolve during several days, in contrast to the rapid onset and hyperkinesia of the serotonin syndrome. Knowledge of the precipitating drug also helps in distinguishing between syndromes: dopamine antagonists produce bradykinesia, whereas serotonin agonists produce hyperkinesia.

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