American Board of Psychiatry and Neurology (ABPN) Practice Exam

In cases of acute agitation in serotonin syndrome, which medication may be used to control these symptoms?

1. Antipsychotics

2. Benzodiazepines

3. SSRIs

4. MAOIs

The correct answer is: Benzodiazepines

In cases of acute agitation associated with serotonin syndrome, benzodiazepines are often used to help manage symptoms effectively. They work by enhancing the effect of the neurotransmitter GABA, which has calming effects on the nervous system. This can be particularly beneficial in reducing anxiety, muscle stiffness, and agitation seen in patients with serotonin syndrome. Unlike some other options, benzodiazepines do not affect serotonin levels, making them a safer choice in this situation. They can provide immediate relief of symptoms, allowing for better overall management while additional treatments for serotonin syndrome are implemented. Moreover, evaluating the patient's condition and providing supportive care, which often includes the use of benzodiazepines, is critical in addressing the symptoms while monitoring for potential complications. In contrast, using antipsychotics might not specifically address the agitation related to serotonin syndrome and could exacerbate symptoms in some cases. SSRIs, being a class of medications that elevate serotonin levels, could potentially worsen the condition. Similarly, MAOIs are contraindicated in the presence of serotonin syndrome due to their effects on serotonin metabolism and potentially heavy interactions with other medications that can increase serotonin levels.