41.下列何者可用於緩解serotonin syndrome？
(A)cyproheptadine
(B)dextromethorphan
(C)linezolid
(D)meperidine

【Serotonin syndrome處理】

1. 停用serotonergic agents

2. 用BZD鎮靜（消除激動、神經肌肉異常（顫抖、陣攣）、心跳血壓上升的症狀）

3. 氧氣、IV輸液

4. 處理高熱 →Etomidate或succinylcholine（不用acetaminophen，因高熱是肌肉所引起，而非下視丘體溫設定點(set point)改變）

若BZD與支持性照護都無法緩解激動、異常生命徵象→給予Cyproheptadine 12 mg（口服，可磨碎管灌）

Cyproheptadine是H₁-blocker也是非專一5-HT_1A和5-HT_2A-blocker

其他不能使用的藥物如7F

參考整理自：
UpToDate: Serotonin syndrome (serotonin toxicity)

不建議使用!!
Treatment with propranolol, bromocriptine, or dantrolene is not recommended.
1.Propranololhas a long duration of action, may cause prolonged hypotension, and can mask tachycardia that can be used to monitor the effectiveness of treatment.
2.Bromocriptine, a serotonin agonist, may exacerbate serotonin syndrome
3.Dantrolene has no effect on survival in animal models.

(B)dextromethorphan 
(C)linezolid 
(D)meperidine 

都可能引起serotonin syndrome

用serotoninnantagonist阻斷serotonin接受體

methysergiden(2-6mg/day)

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cyproheptadine(4-8mg PO→ 4mg Q2-4h，最多0.5mg/kg/day)