▸ Serotonin syndrome, more aptly named serotonin toxicity, is a potentially fatal drug-induced condition caused by too much serotonin in synapses in the brain. Patients present with a combination of neuromuscular, autonomic, and mental status symptoms.
Serotonin syndrome happens when you have too much serotonin (a normal chemical) in your body. It's usually caused by taking drugs or medications that affect serotonin levels. Stopping the drug(s) or medication(s) causing serotonin syndrome is the main treatment.
Serotonin syndrome is diagnosed clinically and requires a thorough review of medications and a careful physical exam. Symptoms tend to develop rapidly after exposure to the precipitating drug: 30% within one hour, 60% within 6 hours, and nearly all patients with toxicity developing symptoms within 24 hours of exposure.
No single test can confirm a serotonin syndrome diagnosis. Your doctor will diagnose the condition by ruling out other possibilities. Your doctor will likely begin by asking about your symptoms, medical history and any medications you're taking. Your doctor will also conduct a physical examination.
Mild serotonin syndrome may cause subtle symptoms, such as mild tremors, restlessness, or headaches. Signs of severe serotonin syndrome include rigid muscles, seizures, fever, and nausea or vomiting.
An estimated 15% of SSRI overdoses lead to mild or moderate serotonin toxicity. Serotonergic agents used in conjunction can increase the risk for severe serotonin syndrome; an SSRI and an MAOI in combination poses the greatest risk.
Serotonin syndrome (SS) is an under diagnosed and under reported condition. Mild SS is easily overlooked by physicians. Every patient with mild SS is a potential candidate for developing life-threatening severe SS because of inadvertent overdose or the addition of the second serotonergic drug.
It is noted that some cases of serotonin syndrome may be mild and go undiagnosed or they could be misdiagnosed, so the true occurrence may be higher. Additionally, because drugs other than SSRIs can cause serotonin syndrome, there are likely more yearly cases of serotonin syndrome than the survey found.
Nonserotonergic antidepressants such as mirtazapine and bupropion are possible alternatives. Most tricyclic antidepressants (e.g., amitriptyline, desipramine and nortriptyline) are also less serotonergic than SSRIs, though clomipramine and imipramine are notable exceptions.
Serotonin syndrome occurs when someone has an excess of the neurotransmitter serotonin in their nervous system. The condition's symptoms generally fall into three categories: Altered mental status (irritability, agitation, restlessness, and anxiety)
Chronic stress is known to affect serotonin (5HT) neurotransmission in the brain and to alter body temperature.
Abstract. Serotonin syndrome is a potentially life-threatening reaction that occurs in patients using drugs that elevate the serotonin level in the body. Excess serotonergic activity in the CNS and peripheral serotonin receptors results in neuromuscular hyperactivity, mental changes and autonomic symptoms.
Diffuse body pain may be an initial presentation of serotonin syndrome. Medications such as ondansetron used to symptomatically treat the nausea and vomiting that may accompany serotonin syndrome can actually exacerbate the condition.
Severe cases may result in complications, such as seizures, rhabdomyolysis, myoglobinuria, metabolic acidosis, renal failure, acute respiratory distress syndrome, respiratory failure, diffuse intravascular clotting, coma, and death.
Alcohol can also temporarily boost the amount of serotonin in the brain. Consuming alcohol while taking antidepressants can lead to very high serotonin levels. Excess serotonin can cause serotonin syndrome, a potentially life threatening condition.
Cases of serotonin syndrome resulting in hospitalization or death are rare. Most cases do not require medication intervention, but can be managed by stopping the drug or decreasing the dose.
Can Serotonin Syndrome Be Reversed? The symptoms of serotonin syndrome usually subside once you stop taking the medication causing the symptoms. Fortunately, there are generally no long-term or lasting complications of serotonin syndrome, though you should be conscious to avoid serotonin syndrome in the future.
Can serotonin syndrome go away naturally? If someone stops taking the serotonin-releasing medication, symptoms from mild serotonin syndrome will go away on their own after 24-72 hours. People with mild symptoms should stay in touch with their healthcare providers but in general they don't need any other treatment.
Most cases of serotonin syndrome present within 24 hours of a change or initiation of a serotonergic drug (table 2). Typical vital sign abnormalities include tachycardia and hypertension, but severe cases may develop hyperthermia and rapid, dramatic swings in pulse and blood pressure.
They found that serotonin produced by these cells is a signal to other neurons in the circuit, leading to an increase in anxiety. Giving mice an SSRI has the same effect on this brain circuit as putting the animals in a fearful situation: Serotonin levels rise and anxiety-like behaviors increase.
It has long been suggested that over-activity of the serotonin system may relate to mood disorders such as depression and anxiety, as these seem characterized by too much withdrawal and avoidance.
Certain drugs and substances such as caffeine, alcohol, nicotine, NutraSweet, antidepressants, and some cholesterol-lowering medications deplete serotonin and other neurotransmitter levels. Hormone changes cause low levels of serotonin and neurotransmitter imbalances.
Antidepressants can cause changes in neurotransmitter levels and brain function; however, these changes are typically reversible once the medication is stopped.
Untreated, serotonin syndrome can be deadly. With treatment, symptoms usually go away in less than 24 hours. Permanent organ damage may result, even with treatment.