Hi everyone, hope your pracs are going well- one to go til we’re physios!
On my rural prac I’ve had the opportunity to watch my supervisor treat patients in ICU. One patient caught my attention as he had been admitted with a condition I’d never seen before. It’s called Serotonin Syndrome, and I thought it was an interesting condition so I thought I’d share what I’ve learnt.
Serotonin Syndrome is an adverse drug reaction that can happen after therapeutic or recreational drug use, and usually involves an interaction between two or more drugs. It’s not a spontaneous reaction; it’s the result of excessive serotonergic activity in the CNS and peripheral serotonin receptors. The most common kinds of drugs which, if combined or used in excess, cause this are anti-depressants, opioids, CNS stimulants, psychedelic drugs (e.g. LSD) and some herbs (like St John’s Wort and Gingko Biloba). Clinical presentations of serotonin syndrome can range from mild to potentially fatal. Milder symptoms can consist of tachycardia, profuse sweating, myoclonus, hypertension, hyperthermia and hyper-responsive reflexes. Severe symptoms include the previous symptoms as well as agitated delirium, muscle rigidity, metabolic acidosis, rhabdomyolysis (muscle breakdown) and renal failure. Most symptoms tend to resolve within 24-72 hours.
In the patient I’ve seen, he had taken a combination of ecstasy, dexamphetamines, cannabis and alcohol. He was also taking three different prescription anti-depressants and anti-psychotics. He has been sedated and intubated in ICU for 11 days, far longer than the 3 days that it should last. His muscles exhibit leadpipe rigidity on muscle testing and he is constantly sweating, even under sedation. He is 24 years old, and there is a possibility that he has suffered brain damage from this condition.
It is an extremely sad situation. It has made me realise that many people don’t know or understand the consequences of mixing medications, and how dangerous it can be.
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2 comments:
This is so sad. The patient is only 24 yo and has so much more ahead of him. Yes it is really dangerous to mix drugs and you never know if one of them was going to react with another one that you are taking. That is why you never self-medicate with drugs. It's always better to see a doctor and get prescribed drugs for whatever condition you are suffering from. Hope your patient gets better though... enjoy the final placement!
thanks for the info... i had never heard of the condition before but as Sarah said; it's really not worth mixing drugs with out consulting your doctor first. It is a sad situation for this patient but you would have to wonder why he was taking so many elicit drugs in the first place... not good.
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