Ankle Clonus a Simple Way to Identify Serotonin Syndrome

[Celebration]

http://www.medscape.com/viewarticle/776124

The prevalence of serotonin syndrome, which, at its most severe, is a potentially life-threatening drug reaction that increases serotonin levels, is strikingly high in patients receiving buprenorphine ( Suboxone, Reckitt Benckiser) on an outpatient basis for opioid addiction, a single-center study shows.

Presented here at the American Academy of Addiction Psychiatry (AAP) 23rd Annual Meeting & Symposium, the study showed that 43% of patients attending a single burprenorphine clinic had mild to moderate serontonin syndrome.

"The Suboxone clinic presented so many cases, so many women having ankle clonus and agitation and tremor, I thought that this was worth reporting. In fact, 43% of our patients showed some degree of serotonin syndrome. Yet, many mild and moderate cases of serotonin syndrome go unrecognized," lead researcher Shawn Cassady, MD, from the First Step clinic, in Cockeysville, Maryland, told Medscape Medical News.

However, he added, the good news is that serotonin syndrome can be easily identified with a simple reflex examination for ankle clonus, involuntary muscular contraction, and relaxation in rapid succession in the ankle.

I hope this test becomes standard for people on SSRIs.

[GreenPartyVoter]

1. I'm still not entirely sure what I was supposed to see? I saw how the test was done, but

am not as clear about how to recognize (as a layperson) the symptoms. I wish the camera had zoomed in so I could see it.

[Celebration]

2. There are probably better explanations out there

The ankle isn't supposed to shake, I *think*, when pressure is put on it.

In any case, I am pretty sure doctors are taught this test in medical school--they just don't know it has anything to do with SSRIs.

[cbayer]

3. This is already a well known indicator of serotonin syndrome

and, of course, there are many others.

Very few patients on SSRI's, develop this syndrome. Good clinicians will ask about and observe for symptoms.

Doing a test for ankle clonus would just be silly.

[Celebration]

4. um, so you disagree with this?

"Yet, many mild and moderate cases of serotonin syndrome go unrecognized."

[cbayer]

5. I agree that mild serotonin syndrome is probably not a problem and

that most clinicians are watching our for anything significant.

[SCassadyMD]

6. Spam deleted by uppityperson (MIR Team)