You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A patient is on both Clomipramine and Escitalopram. We should monitor him for and explain in detail?
(B) Serotonin syndrome # Clomipramine oral & Escitalopram oral both increase affecting serotonin levels in the blood.> Too much serotonin is a potentially life-threatening situation. Severe signs and symptoms include high blood pressure and increased heart rate that lead to shock.> Symptoms of this potentially dangerous Serotonin syndrome range from minimal in patients starting selective serotonin reuptake inhibitors (SSRIs) to fatal in those combining monoamine oxidase inhibitors (MAOIs) with serotonergic agents.# Serotonin syndrome is characterized by changes in autonomic, neuromotor, and cognitive-behavioral function triggered by increased serotonergic stimulation.> It typically results from pharmacodynamic and/or pharmacokinetic interactions between drugs that increase serotonin activityRECOGNITION OF SEROTONIN SYNDROMESystemClinical Signs & Symptoms* AutonomicDiaphoresis, hyperthermia, hypertension, tachycardia, pupillary dilatation, nausea, diarrhea, shivering* NeuromotorHyperreflexia, myoclonus, restlessness, tremor, incoordination, rigidity, clonus, teeth chattering, trismus, seizures* Cognitive-behavioralConfusion, agitation, anxiety, hypomania, insomnia, hallucinations, headache# Most Moclobemide-SSRI interactions--including fatalities--involved overdoses in suicide attempts, although toxic symptoms have been reported with clomipramine or meperidine taken at normal dosages.> Switch medication from clomipramine to Escitalopram.> Stop clomipramine> Before day 1: Gradually reduce dosage of clomipramine to a maximum of 50 mg/day.> Day 1: Reduce dosage of clomipramine to 25 mg/day.> Day 3: Reduce dosage of clomipramine to 10 mg/day.> Day 8: Stop administration of clomipramine. Start Escitalopram> Day 1: Simultaneously start administration of escitalopram in a normal dosage of 10 mg/day.