Opioid Analgesics Association with Serotonin Syndrome in Patients Taking Antidepressant Medications

Abstract

Serotonin syndrome (SS) is a potentially life-threatening condition that is often under-diagnosed in the clinical setting. Serotonin toxicity occurs when there is an excessive amount of serotonin in the body leading to neuronal hyperstimulation. In the United States, there is widespread use of serotonergic psychiatric medications in the general population. This is a particular concern to anesthesia providers, not only in the perioperative setting, where many serotonergic medications are administered, but also in pain clinics where the prescribing of opioids is a common practice. Recent publications, including several case studies, literature reviews, and randomized control trials have indicated that there is an increased risk of SS when opioids are used in patients already taking serotonergic antidepressant medications. Continuing education is vital to the professional development of anesthesia providers and it is imperative to educate not only on potential drug interactions, but the signs and symptoms as well as treatment options for patients that develop SS. Continuing education in the form of online modules provides advantages including self-paced learning, lower cost, and a more comfortable learning environment. The aim of this project was to assess the feasibility of an AdventHealth University (AHU) Student Registered Nurse Anesthetist (SRNA) developed one-hour module on opioid analgesics association with SS in patients taking serotonergic antidepressant medications being approved for continuing education (CE) credit by the American Association of Nurse Anesthetists (AANA). Information was obtained from multiple resources: experts in continuing education, a feasibility study, and professional guidance in writing objectives and test questions, through interviews, both in person and virtually.

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