Untitled Slide
“FARM”: Fever, Altered mental status, Rigidity, Myoclonus
The clinical picture of serotonin toxicity can best be described as a triad of cognitive, autonomic and somatic effects. In mild cases, the cognitive effects may simply consist of abnormal mood, such as hypomania, but in severe cases, mental status is altered and patients may experience severe agitation and hallucinations. The autonomic effects consist of diaphoresis, hypertension, hyperthermia, tachycardia and diarrhea. In severe cases, marked hyperthermia can give rise to additional complications, such as rhabdomyolysis, seizures, metabolic acidosis and disseminated intravascular coagulation. Finally, the somatic effects are essential for the diagnosis; these are myoclonus, tremor and hyperreflexia with clonus.