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Serotonin syndrome — GPhC CRA MCQ

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HardCNS TherapeuticsSerotonin syndromeGPhC CRA

A 37-year-old man taking sertraline is prescribed tramadol for acute back pain. Two days later he attends confused, sweating and tremulous with diarrhoea and pulse 118 bpm. What is the most important interaction to flag?

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Correct answer: C — Refer urgently for suspected serotonin syndrome

Tramadol has serotonergic activity and can precipitate serotonin syndrome when combined with SSRIs. Confusion, autonomic instability, tremor and diarrhoea support the diagnosis. Urgent medical assessment is needed because severe cases can deteriorate quickly. Continuing both medicines or symptomatic OTC treatment would be unsafe.

Reference: BNF