Toxicology: serotonin syndrome: practice question

A Forensic Medicine 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.

Try it

Forensic Medicine · Toxicology: serotonin syndrome

Sample item

A patient taking sertraline is started on linezolid and soon has agitation, sweating, temperature of 39 degrees Celsius, tremor, hyperreflexia and inducible ankle clonus. Which drug serves as an antidote?

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

The answer and the reasoning

C. Cyproheptadine

This is serotonin syndrome, with neuromuscular hyperactivity, autonomic instability and altered mental state. Stopping the drugs, benzodiazepines and cooling are the first measures, and the 5-HT2A antagonist cyproheptadine is the antidote. Dantrolene and bromocriptine are used in malignant hyperthermia and neuroleptic malignant syndrome, and haloperidol may worsen the condition.

Option by option

  • A. Dantrolene

    Dantrolene is used for malignant hyperthermia and is not an established treatment for this condition.

  • B. Haloperidol

    Haloperidol is a dopamine blocker that may aggravate hyperthermia.

  • C. Cyproheptadine (correct)

    Correct. Cyproheptadine blocks the serotonin receptors involved.

  • D. Bromocriptine

    Bromocriptine is used in neuroleptic malignant syndrome and can worsen serotonin toxicity.

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.

More Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Cyproheptadine. This is serotonin syndrome, with neuromuscular hyperactivity, autonomic instability and altered mental state.

Why is "Dantrolene" not the answer?

Dantrolene is used for malignant hyperthermia and is not an established treatment for this condition.

Why is "Haloperidol" not the answer?

Haloperidol is a dopamine blocker that may aggravate hyperthermia.

Why is "Bromocriptine" not the answer?

Bromocriptine is used in neuroleptic malignant syndrome and can worsen serotonin toxicity.

What concept does this question test?

It tests Toxicology: serotonin syndrome in Forensic Medicine. Stopping the drugs, benzodiazepines and cooling are the first measures, and the 5-HT2A antagonist cyproheptadine is the antidote. Dantrolene and bromocriptine are used in malignant hyperthermia and neuroleptic malignant syndrome, and haloperidol may worsen the condition.

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 Toxicology: serotonin syndrome?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.