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3.15.3 - Overdose, Serotonin Syndrome and Neuroleptic Malignant Syndrome

from Section 3.15 - Psychiatric Disorders Encountered in Intensive Care

Published online by Cambridge University Press:  27 July 2023

By
Ruth Taylor  and
Peter Byrne
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Features of overdose depend on the type of antidepressant or anti-psychotic agent taken.

  2. 2. All patients suspected of overdose must be monitored for QRS/QT prolongation.

  3. 3. In some overdoses (monoamine oxidase inhibitors, hypoglycaemic agents, long-acting insulin, anticoagulants), onset of symptoms may be delayed; an asymptomatic patient may still require admission and treatment in the intensive care unit.

  4. 4. Serotonin syndrome is a medical emergency defined as an adverse reaction to serotonergic agents.

  5. 5. Neuroleptic malignant syndrome is a medical emergency caused by an idiosyncratic reaction to neuroleptic medication.

Keywords

salicylateanti-cholinergicserotonergic agentneuroleptics
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 441 - 444
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Ambulkar, RP, Patil, VP, Moiyadi, AV. Neuroleptic malignant syndrome: a diagnostic challenge. J Anaesthesiol Clin Pharmacol 2012;28:517–19.CrossRefGoogle ScholarPubMed
Boyer, EW, Shannon, M. The serotonin syndrome. N Engl J Med 2005;352:1112–20.CrossRefGoogle ScholarPubMed
Kateon, H. Differentiating serotonin syndrome and neuroleptic malignant syndrome. Mental Health Clinician 2013;3:129–33.CrossRefGoogle Scholar
National Organization for Rare Disorders. 2004. Neuroleptic malignant syndrome. rarediseases.org/rare-diseases/neuroleptic-malignant-syndrome/Google Scholar
Sternbach, H. The serotonin syndrome. Am J Psychiatry 1991;148:705–13.Google ScholarPubMed

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