Summary
For serotonin syndrome management: administer a 12 mg oral loading dose, then 2 mg every 2 hours until clinical improvement (max 32 mg/24 hours); thereafter give 4-8 mg every 6 hours as needed. Monitor for over-sedation, urinary retention, delirium, and hepatic enzymes in prolonged courses. May interfere with hemostasis and prolong bleeding time. Not approved for use in newborns or premature infants.
Dose Information
Light
Common
Strong
Heavy
Onset, Duration & After-effects
| ROA | Onset | Comeup | Peak | Offset | After Effects |
|---|---|---|---|---|---|
| Oral | 30-60 min | 1-3 hrs | 2-6 hrs | 2-4 hrs | 24 hrs |
Tolerance
Build-up
develops over 1–4 weeks of regular use
Reset
days to weeks depending on duration of use
Effects
Positive
- Appetite Stimulation
- Antipruritic Relief
- Muscle relaxation
Negative
- Dry Mouth
- Motor Coordination Suppression
- Dry mouth
- Increased heart rate
- Muscle cramps
- Nausea
- Sedation
Positive
- Relaxation
- Reduced anxiety
Negative
- Drowsiness
- Cognitive Impairment
- Delirium
- Confusion
- Dysphoria
- Anxiety
- Paranoia
- Dizziness
Positive
Negative
- Blurred Vision
- Blurred vision
- Dulled perception
- External hallucinations
- Internal hallucinations
- Visual and audio distortions
- Perception of Bodily Heaviness
- External Hallucination
- Auditory Hallucination
- External hallucination