yes john I am still lurking on the list!
Yes i agree it could be a serotonin syndrome which is 3 of the following
present
agitation ,mental status changes , diaphoresis myoclonus diarrhoea fever
hyperreflexia tremor and incoordination and a history of ingestion of
serotonin releasing drugs
But most of the cases we came across were large doses of SSRIs ( I think
there was a case of venlafaxine OD causing serotonin syndrome in the
british A & E journal recently ) or they had taken something else which
increased serotonin usually an MOA B inhibitor , do you think he could
have taken someting else i.e esctasy.
cyproheptadine would have been a good idea but he was a bit sicker than
our patients all who got better after 1 or 2 doses .
the only problems are that there is no i.v peparation and hence it will
not work if used in conjunction with charcoal.
Andy Stearman
Spr A & E poole dorset
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