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Síndrome serotoninérgica

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  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 28 Nov 2025
Última actualización: 07 Oct 2022

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença de fatores de risco
  • clônus
  • hiper-reflexia
Todos los datos

Otros factores de diagnóstico

  • ansiedade
  • agitação
  • confusão
  • tremores, espasmos musculares
  • sudorese
  • cefaleia
  • taquicardia
  • hipertonia/rigidez
  • diaforese
  • rubor
  • pupilas dilatadas
  • hipertermia
  • mioclonia
  • estimulação
Todos los datos

Factores de riesgo

  • exposição a um medicamento serotoninérgico
  • exposição a dois ou mais medicamentos serotoninérgicos
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Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • diagnóstico clínico
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Pruebas diagnósticas que deben considerarse

  • Hemograma completo
  • creatina fosfoquinase
  • eletrocardiograma (ECG)
  • hemoculturas
  • punção lombar
  • tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) do crânio
Todos los datos

Algoritmo de tratamiento

Agudo

toxicidade serotoninérgica grave

toxicidade serotoninérgica moderada

toxicidade serotoninérgica leve

Colaboradores

Autores

Geoffrey Isbister, BSc, MBBS, FACEM, MD

Clinical Toxicologist

Calvary Mater Newcastle

Associate Professor

University of Newcastle

Newcastle

Australia

利益声明

GI is an author of several references cited in this monograph.

同行评议者

Laura Tormoehlen, MD, FAAN, FACMT

Neurologist and Medical Toxicologist

Associate Professor of Clinical Neurology and Emergency Medicine

Indiana University

Bloomington

IN

利益声明

LT has been compensated as an expert witness for cases involving serotonergic drugs.

Daniel E Brooks, MD

Medical Director

Banner Poison and Drug Information Center

Phoenix

AZ

利益声明

DEB declares that he has no competing interests.

Karl Marlowe, MbChB, MSc, PgC-Ed, PgD-CBT, MRCPsych

Consultant Psychiatrist

East London NHS Foundation Trust

London

UK

利益声明

KM declares that he has no competing interests.

Theodore A. Stern, MD

Chief

Psychiatric Consultation Service

Massachusetts General Hospital

Professor of Psychiatry

Harvard Medical School

Boston

MA

利益声明

TAS declares that he has no competing interests.

Paul M. Gahlinger, MD

Adjunct Professor

Department of Family and Preventive Medicine

University of Utah

Salt Lake City

UT

利益声明

PMG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Buckley NA, Dawson AH, Isbister GK. Serotonin syndrome. BMJ. 2014;348:g1626 摘要

Isbister GK, Buckley NA. The pathophysiology of serotonin toxicity in animals and humans: implications for diagnosis and treatment. Clin Neuropharmacol. 2005;28:205-214. 摘要

Dunkley EJ, Isbister GK, Sibbritt D, et al. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96:635-642.全文  摘要

Chiew AL, Buckley NA. The serotonin toxidrome: shortfalls of current diagnostic criteria for related syndromes. Clin Toxicol (Phila). 2022 Feb;60(2):143-58. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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