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Unsuspected serotonin toxicity in the ICU

Overview of attention for article published in Annals of Intensive Care, September 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (75th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

Mentioned by

13 tweeters


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33 Mendeley
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Unsuspected serotonin toxicity in the ICU
Published in
Annals of Intensive Care, September 2016
DOI 10.1186/s13613-016-0186-9
Pubmed ID

Catharina E. Ewijk, Gabriel E. Jacobs, Armand R. J. Girbes, van Ewijk, Catharina E, Jacobs, Gabriel E, Girbes, Armand R J, Catharina E. van Ewijk


Delirium is a frequently occurring syndrome in patients admitted to the intensive care unit (ICU) or medium care unit (MCU), yet the pathophysiology remains poorly understood. An excess of central serotonin can lead to an altered mental status, associated with autonomic hyperactivity, and neuromuscular excitation. Drugs with serotonergic properties are frequently and for prolonged periods administered to ICU/MCU patients. Therefore, central serotonergic toxicity may constitute a predisposing, contributing or precipitating factor in the emergence of delirium. The purpose of the present study is to determine the number of patients admitted to the ICU or MCU who are diagnosed with delirium and who show characteristics of serotonin toxicity in association with the administration of serotonergic drugs. During a 10-week prospective observational cohort study in the ICU and MCU, patients aged 18 or older, diagnosed with delirium in the ICU or MCU, were included. Patients were considered as delirious in case of a positive CAM-ICU and/or at the start of haloperidol prescription on suspicion of delirium. Once included, patients were screened for recent administered serotonergic drugs and screened for physical signs associated with serotonin toxicity by a standardized physical examination by a specifically trained physician. A total of 61 patients diagnosed with delirium were enrolled. In 44 out of 61 patients (72 %), the use of drugs potentially contributing to serotonergic toxicity was recorded. Out of 44 patients, seven (16 %) patients showed physical signs of serotonin toxicity and in addition met the Hunter serotonin toxicity criteria, suggesting the presence of serotonergic toxicity. None of these patients were recognized as such by the treating physicians. A significant proportion of delirious patients in the ICU might in fact be classified as suffering from central serotonin toxicity. The awareness of potential serotonin toxicity is low among physicians.

Twitter Demographics

The data shown below were collected from the profiles of 13 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Czechia 1 3%
Unknown 32 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 21%
Student > Master 6 18%
Other 3 9%
Student > Doctoral Student 2 6%
Professor 1 3%
Other 4 12%
Unknown 10 30%
Readers by discipline Count As %
Medicine and Dentistry 17 52%
Pharmacology, Toxicology and Pharmaceutical Science 2 6%
Neuroscience 2 6%
Biochemistry, Genetics and Molecular Biology 1 3%
Unspecified 1 3%
Other 1 3%
Unknown 9 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 August 2020.
All research outputs
of 15,824,164 outputs
Outputs from Annals of Intensive Care
of 704 outputs
Outputs of similar age
of 266,064 outputs
Outputs of similar age from Annals of Intensive Care
of 11 outputs
Altmetric has tracked 15,824,164 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 704 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.7. This one has gotten more attention than average, scoring higher than 61% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,064 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 11 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.