A 52-year-old man with treatment-resistant major depressive disorder has been taking phenelzine 45 mg daily for 8 months with adequate symptom control. His psychiatrist adds sertraline 50 mg daily, and 1 week later the patient presents to the emergency department with confusion, agitation, and severe muscle rigidity. Vital signs: BP 158/92 mmHg, HR 118 bpm, RR 22/min, T 38.9°C. On examination, he has spontaneous clonus, brisk reflexes, and is diaphoretic. Laboratory studies show creatine kinase 1200 U/L, sodium 138 mEq/L, and myoglobinuria. The patient denies recent fevers, sick contacts, or exposure to new medications other than sertraline. Which of the following is the most likely diagnosis?
- A)Serotonin syndromeGABARITO
- B)Neuroleptic malignant syndrome
- C)Malignant hyperthermia
- D)Anticholinergic toxicity
- E)Sepsis with acute encephalitis
Explicação
Serotonin syndrome results from excessive serotonergic activity in the CNS and is caused by concurrent use of medications that increase serotonin levels. Phenelzine is a non-selective MAOI that inhibits serotonin metabolism, while sertraline is an SSRI that in... Ver explicação completa e trilha adaptativa →