Dexmedetomidine in the Treatment of Serotonin Syndrome
Objective: Patients suffering from moderate to severe serotonin syndrome frequently present with autonomic instability and altered mental status. Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2014-12, Vol.48 (12), p.1651-1654 |
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| container_title | The Annals of pharmacotherapy |
| container_volume | 48 |
| creator | Rushton, William F. Charlton, Nathan P. |
| description | Objective: Patients suffering from moderate to severe serotonin syndrome frequently present with autonomic instability and altered mental status. Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present 3 cases of serotonin syndrome that demonstrated clinical improvement with initiation of dexmedetomidine. Case Series: We present 3 cases of severe serotonin syndrome in adolescents requiring intubation that were refractory to midazolam and/or propofol. Dexmedetomidine, an α-2 receptor agonist, was used in all 3 cases with temporal stabilization of the autonomic nervous system and improvement of agitation, and aided in successful extubation. Discussion: Although no human studies exist, rat and mouse models offer evidence that dexmedetomidine can reduce serotonin excess and stabilize signs of serotonin neurotoxicity. Conclusion: Accordingly, health care providers may consider using dexmedetomidine as adjunctive therapy for cases of severe serotonin syndrome that are refractory to standard treatment. |
| doi_str_mv | 10.1177/1060028014549184 |
| format | Article |
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Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present 3 cases of serotonin syndrome that demonstrated clinical improvement with initiation of dexmedetomidine. Case Series: We present 3 cases of severe serotonin syndrome in adolescents requiring intubation that were refractory to midazolam and/or propofol. Dexmedetomidine, an α-2 receptor agonist, was used in all 3 cases with temporal stabilization of the autonomic nervous system and improvement of agitation, and aided in successful extubation. Discussion: Although no human studies exist, rat and mouse models offer evidence that dexmedetomidine can reduce serotonin excess and stabilize signs of serotonin neurotoxicity. 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Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present 3 cases of serotonin syndrome that demonstrated clinical improvement with initiation of dexmedetomidine. Case Series: We present 3 cases of severe serotonin syndrome in adolescents requiring intubation that were refractory to midazolam and/or propofol. Dexmedetomidine, an α-2 receptor agonist, was used in all 3 cases with temporal stabilization of the autonomic nervous system and improvement of agitation, and aided in successful extubation. Discussion: Although no human studies exist, rat and mouse models offer evidence that dexmedetomidine can reduce serotonin excess and stabilize signs of serotonin neurotoxicity. Conclusion: Accordingly, health care providers may consider using dexmedetomidine as adjunctive therapy for cases of severe serotonin syndrome that are refractory to standard treatment.</description><subject>Adolescent</subject><subject>Adrenergic alpha-Agonists - therapeutic use</subject><subject>Benzodiazepines - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Dexmedetomidine - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Midazolam - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Propofol - therapeutic use</subject><subject>Psychomotor Agitation - complications</subject><subject>Psychomotor Agitation - drug therapy</subject><subject>Serotonin Syndrome - complications</subject><subject>Serotonin Syndrome - drug therapy</subject><subject>Treatment Failure</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1LAzEQxYMotlbvnmQvHldnsmk-jlI_oeCh9bxkN4lu6W5KsgX735uyVUHwNAPv92Z4j5BLhBtEIW4ROACVgGzKFEp2RMY4ZTTnVMBx2pOc7_UROYtxBQAKqTolIzpFriiTY8Lv7Wdrje1925ims1nTZf2HzZbB6r61XZ95ly1s8L3vkrTYdSb41p6TE6fX0V4c5oS8PT4sZ8_5_PXpZXY3z-uCiz4XrGYGTaG4AyWQUlEjB6asQKNRS8ddwaSuKlO5impNJTVFpSwwqZTRVTEhMNytg48xWFduQtPqsCsRyn0F5d8KkuVqsGy2VUr2Y_jOnIDrA6Bjrdcu6K5u4i8nFeeAInH5wEX9bsuV34YuRf3_8RfazG-l</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Rushton, William F.</creator><creator>Charlton, Nathan P.</creator><general>SAGE Publications</general><general>Whitney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20141201</creationdate><title>Dexmedetomidine in the Treatment of Serotonin Syndrome</title><author>Rushton, William F. ; Charlton, Nathan P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-74c4d1d396f0971227c16049e71da1a8f6f348abbdbfb2aa282d3b9e04899dab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adrenergic alpha-Agonists - therapeutic use</topic><topic>Benzodiazepines - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Dexmedetomidine - therapeutic use</topic><topic>Female</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Midazolam - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Propofol - therapeutic use</topic><topic>Psychomotor Agitation - complications</topic><topic>Psychomotor Agitation - drug therapy</topic><topic>Serotonin Syndrome - complications</topic><topic>Serotonin Syndrome - drug therapy</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rushton, William F.</creatorcontrib><creatorcontrib>Charlton, Nathan P.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rushton, William F.</au><au>Charlton, Nathan P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dexmedetomidine in the Treatment of Serotonin Syndrome</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>48</volume><issue>12</issue><spage>1651</spage><epage>1654</epage><pages>1651-1654</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><coden>APHRER</coden><abstract>Objective: Patients suffering from moderate to severe serotonin syndrome frequently present with autonomic instability and altered mental status. Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present 3 cases of serotonin syndrome that demonstrated clinical improvement with initiation of dexmedetomidine. Case Series: We present 3 cases of severe serotonin syndrome in adolescents requiring intubation that were refractory to midazolam and/or propofol. Dexmedetomidine, an α-2 receptor agonist, was used in all 3 cases with temporal stabilization of the autonomic nervous system and improvement of agitation, and aided in successful extubation. Discussion: Although no human studies exist, rat and mouse models offer evidence that dexmedetomidine can reduce serotonin excess and stabilize signs of serotonin neurotoxicity. 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| ispartof | The Annals of pharmacotherapy, 2014-12, Vol.48 (12), p.1651-1654 |
| issn | 1060-0280 1542-6270 |
| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Adolescent Adrenergic alpha-Agonists - therapeutic use Benzodiazepines - therapeutic use Biological and medical sciences Dexmedetomidine - therapeutic use Female Humans Hypnotics and Sedatives - therapeutic use Male Medical sciences Midazolam - therapeutic use Pharmacology. Drug treatments Propofol - therapeutic use Psychomotor Agitation - complications Psychomotor Agitation - drug therapy Serotonin Syndrome - complications Serotonin Syndrome - drug therapy Treatment Failure |
| title | Dexmedetomidine in the Treatment of Serotonin Syndrome |
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