How to diagnose serotonin syndrome
Diagnosing serotonin syndrome requires a comprehensive evaluation combining medication history assessment, recognition of clinical manifestations, physical examination findings, laboratory tests, and exclusion of other diseases to ensure accurate diagnosis and avoid misdiagnosis or missed diagnosis. If abnormal symptoms occur after taking relevant medications, immediate medical attention is necessary.
1. Medication history assessment: Focus on whether the patient has used serotonergic drugs, such as selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs), or recently increased drug dosage or combined multiple medications—this is a critical prerequisite for diagnosis.
2. Clinical manifestation recognition: Observe for typical symptoms such as altered mental status (agitation, delirium), autonomic nervous system dysfunction (hyperthermia, tachycardia), and neuromuscular abnormalities (tremor, muscle rigidity). Symptoms typically appear shortly after drug administration.
3. Physical examination judgment: Confirm the presence of signs such as myoclonus, hyperreflexia, and ataxia through physical examination. Monitor vital signs including body temperature, heart rate, and blood pressure to assess the severity of autonomic instability, providing evidence for diagnosis.
4. Laboratory test support: Perform complete blood count, biochemical tests, and creatine kinase (CK) measurements to rule out other conditions such as infection, electrolyte imbalance, or rhabdomyolysis. Elevated creatine kinase levels may be observed in some patients, aiding differential diagnosis.
5. Exclusion of other diseases: Differentiate serotonin syndrome from conditions such as malignant hyperthermia, neuroleptic malignant syndrome, and meningitis, which present with similar symptoms. A comprehensive evaluation of medical history, clinical features, and test results helps exclude alternative diagnoses.
Daily care: Strictly follow medical instructions when taking medications—do not adjust dosages or combine drugs without guidance. Pay attention to bodily changes during treatment, record any adverse reactions, maintain regular作息 (daily routines), avoid excessive fatigue, eat light and easily digestible meals, and support overall physiological stability.
