Serotonin syndrome

Once the patient has recovered, no further monitoring is required unless a serotonergic agent is reintroduced. The level of monitoring with reintroduction should be based on the severity of the serotonin toxicity that occurred and the relative doses being used. For example, if only mild serotonin toxicity occurred, then outpatient monitoring would be appropriate.

Depending on the situation that has led to the serotonin toxicity (e.g., increased dose, overdose, drug-drug interaction), a single serotonergic medication may be restarted at a lower dose after the condition has resolved, while the patient is monitored closely. If the serotonin syndrome resulted from a drug-drug interaction, specifically use/overdose of an illicit substance, you can restart the patient’s prescribed medication at their normal dose.