TABLE 1531 Serotonergic Potential of Various Drugs

The true incidence and severity of serotonin syndrome are unknown. Prospective studies on serotonin syndrome tend to overestimate its incidence and underestimate its severity. Conversely, case reports are often associated with incomplete documentation and tend to overestimate the severity and underestimate the incidence of serotonin syndrome. The most commonly reported signs and symptoms associated with serotonin syndrome are listed in Table 153-2.. Interestingly, muscle rigidity, when present, is especially prominent in the lower extremities. This finding can serve as a valuable clinical marker for serotonin syndrome. Patients with ataxia should be carefully examined for lower extremity hypertonia. Unilateral muscle rigidity or focal neurologic findings have not been reported. Seizures are always generalized and usually short-lived. Hyperthermia is usually of moderate severity, but temperatures greater than 106°F (41°C) are not rare. Hypertension is twice as common as hypotension and is associated with a more favorable prognosis.

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