Liverpool Hospital Emergency Department
- Serotonin syndrome (mild to mod)
- Antagonises – H1 and 5HT1+2 Receptors
- Not an antidote -> helps to alleviate symptoms
- Serotonin syndrome: CNS toxicity/ Autonomic features/ Neuromuscular excitability.
- Consider the use of oral benzodiazepines in cooperative patients with mild to moderate agitation.
- Cyproheptadine 4mg tablets
Dosage and Administration
- For patients with significant agitation and sustained clonus use 12mg as a single dose
- Continue with 8mg PO / NG TDS for 24hrs until resolution of symptoms o Paediatrics
- <7 years of age 2mg as a single dose.
- >7 years of age 4mg as a single dose.
- Continued symptoms <7 years of age 2mg tds
- >7 years of age 4mg tds until symptom resolution
- Anticholinergic properties but generally well tolerated
- Contraindicated in:
- Acute asthma, closed angle glaucoma, bladder neck obstruction
- Use alongside benzodiazepines & supportive care