Adverse syndromes and psychiatric drugs: a clinical guide by Peter M. Haddad, Serdar Dursun, Bill Deakin

By Peter M. Haddad, Serdar Dursun, Bill Deakin

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Extra resources for Adverse syndromes and psychiatric drugs: a clinical guide

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Qxd 5/5/04 5:37 PM Page 37 Chapter 3 Serotonin syndrome Ken Gillman and Ian M Whyte Introduction There have been many deaths caused by serotonin (5-hydroxytryptamine, 5-HT) toxicity (serotonin syndrome) approximately 50 of which have been described in the literature. This book will arrive in time to mark the fiftieth anniversary of the first of these reported fatalities (Mitchell 1955). Serotonin toxicity reactions continue to result from therapeutic drug combinations that predictably cause this interaction.

Int Clin Psychopharmacol, 10 (Suppl. 3), 115–21. qxd 5/5/04 5:31 PM Page 18 18 ADVERSE SYNDROMES AND PSYCHIATRIC DRUGS: A CLINICAL GUIDE Barnes TRE and McPhillips MA (1996). Antipsychotic-induced extrapyramidal symptoms: role of anticholinergic drugs in treatment. CNS Drugs, 6, 315–30. Beasley CM Jr, Tollefson G, Tran P, et al. (1996). Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Neuropsychopharmacology, 14, 111–23. Blom S and Ekbom KA (1961).

In severe cases of NMS, there can be widespread breakdown of skeletal muscle (rhabdomyolysis) leading to uraemia, myoglobinuria and acute renal failure. Leucocytosis occurs in most cases (Shalev and Munitz 1986). Other biochemical findings such as hypo- or hypernatraemia or metabolic acidosis and low serum iron levels have been noted (Rosebush and Stewart 1989; Rosebush and Mazurek 1991). Studies on central nervous system imaging, electroencephalogram (EEG) and lumbar puncture have not yielded any significant results but only nonspecific and non-conclusive changes.

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