Approach

Diagnosis of serotonin toxicity is primarily clinical, and diagnostic tests are rarely required. Toxicity is characterised by a triad of clinical features (neuromuscular excitation, autonomic effects, and altered mental status) in combination with a history of exposure to a serotonergic drug.[1][2] It is important to establish whether serotonin toxicity is mild, moderate, or severe, as this guides treatment.[3] A number of clinical diagnostic criteria have been used for serotonin toxicity, but those currently recommended are the Hunter Serotonin Toxicity Criteria (HSTC).[4]

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