Investigations

1st investigations to order

clinical diagnosis

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Diagnosis of serotonin toxicity is primarily clinical, and diagnostic tests are rarely required unless other differential diagnoses are being considered.

Result

features of serotonin toxicity

Investigations to consider

FBC

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Performed in patients with suspected infection.

Result

may be normal, may show leukocytosis if infection is present

creatine phosphokinase

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Result
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Performed in patients who present with clonus to assess for rhabdomyolysis and to exclude other causes.

Result

may be elevated

ECG

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Result
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An ECG may be performed in patients with suspected serotonin toxicity because some agents also cause cardiac toxicity (QT prolongation), importantly citalopram and escitalopram.

Result

may show tachycardia

blood cultures

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Considered to help exclude central nervous system infection as a cause of the patient’s symptoms.

Result

normal

lumbar puncture

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Result
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Considered to help exclude central nervous system infection as a cause of the patient’s symptoms.

Result

normal

CT or MRI head

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Result
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Considered to help exclude central nervous system infection as a cause of the patient’s symptoms.

Result

normal

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