Serotonin syndrome — MCCQE Part 1 MCQ

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HardToxidromeSerotonin syndromeMCCQE Part 1

A 41-year-old woman taking sertraline starts linezolid and presents with agitation, diarrhoea, fever, tremor, inducible clonus and hyperreflexia. Which of the following is the most likely diagnosis?

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Correct answer: A — Serotonin syndrome

Serotonin syndrome is suggested by serotonergic exposure, rapid onset, clonus, hyperreflexia and autonomic findings. Neuroleptic malignant syndrome is typically slower with lead-pipe rigidity and dopamine antagonist exposure. Management includes stopping serotonergic drugs, supportive care, benzodiazepines and cyproheptadine in selected cases.

Reference: Canadian toxicology practice; CAMH psychopharmacology resources