Here’s an article breaking down what a patient with an encounter of emergent SS looks like.
https://www.medpagetoday.com/blogs/doing-time/75647
S&S:
1. Neuromuscular hyperactivity:muscle twitching, tremor, and hyperreflexia.
2. Autonomic effects: tachycardia, hypertension, hyperthermia, sweating, and shivering.
3. Mental status effects: anxiety, agitation, hypomania, confusion, and hallucinations.
Mild cases of serotonin syndrome may only manifest as tremor, hyperreflexia, tachycardia, and sweating.
Moderately severe patients will additionally have an increased temperature, clonus, and agitation.
Patients with severe serotonin syndrome are typically delirious, hallucinating, and have very high temperatures (sometimes over 106° F), which can lead to all sorts of bad effects, like rhabdomyolysis, seizures, renal failure, and yes, death.
I went through her med list more closely and she’s on Sertaline, Buspar, Amytriptaline, Rizatriptan daily and Zofran and Aprepitant prn. ALL of these have some degree of increased seretonergic activity, but especially the first three. Then she’s on Clonazepam which is the only drug on the list that will bring down the damn seretonin. Then she’s on all these other migrain meds and meds for schizophrenia, both of which can be actual symptoms from too much seretonin. Same goes for the damned IBS and n&v. She needs to go into a psych ward and medically overseen detox, like yesterday and come off this shit and see what she actually has and does not have, before she kills herself. I cannot believe any doctor would be so dumb as to prescribe all of these but I’ve seen a few in my days. Two serotonergic drugs alone is cause to be extremely cautious, but this many?! Have I mentioned doctors need more than one class in pharmacology?
End sperg.
