Antidepressants: serotonin syndrome: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Antidepressants: serotonin syndrome

Sample item

A patient on sertraline is given tramadol for pain and develops agitation, diaphoresis, hyperreflexia, inducible ankle clonus and temperature of 39 C. The drug that can be used as an antidote is:

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cyproheptadine

Serotonin syndrome features neuromuscular excitation (clonus, hyperreflexia), autonomic instability and altered mental state, and arises from serotonergic combinations such as SSRI with tramadol or MAOI. Treatment is stopping the drugs, benzodiazepines and cyproheptadine, a 5-HT2A antagonist.

Option by option

  • A. Bromocriptine

    Bromocriptine is a dopamine agonist used in NMS and can worsen serotonin syndrome.

  • B. Flumazenil

    Flumazenil reverses benzodiazepines.

  • C. Dantrolene

    Dantrolene is used in NMS and malignant hyperthermia.

  • D. Cyproheptadine (correct)

    Correct. Cyproheptadine blocks 5-HT2A and is the antidote.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Cyproheptadine. Serotonin syndrome features neuromuscular excitation (clonus, hyperreflexia), autonomic instability and altered mental state, and arises from serotonergic combinations such as SSRI with tramadol or MAOI.

Why is "Bromocriptine" not the answer?

Bromocriptine is a dopamine agonist used in NMS and can worsen serotonin syndrome.

Why is "Flumazenil" not the answer?

Flumazenil reverses benzodiazepines.

Why is "Dantrolene" not the answer?

Dantrolene is used in NMS and malignant hyperthermia.

What concept does this question test?

It tests Antidepressants: serotonin syndrome in Psychiatry. Treatment is stopping the drugs, benzodiazepines and cyproheptadine, a 5-HT2A antagonist.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidepressants: serotonin syndrome?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.