Serotonin Syndrome

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Template:Serotonin Syndrome Infobox

Serotonin syndrome is a potentially life-threatening condition resulting from increased serotonin levels in the central nervous system. It is characterized by a range of clinical manifestations, from mild to severe, that can include cognitive, autonomic, and somatic effects.

Causes[edit | edit source]

Serotonin syndrome is most commonly caused by the use of serotonergic drugs, either alone or in combination. These drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and others such as tricyclic antidepressants, opioids, and serotonin receptor agonists. Overdose of these medications or interactions between multiple serotonergic agents can precipitate the syndrome.

Symptoms[edit | edit source]

The symptoms of serotonin syndrome can be classified into three broad categories:

  • Cognitive effects: confusion, agitation, hypomania, hallucinations, coma.
  • Autonomic effects: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea.
  • Somatic effects: myoclonus (muscle twitching), hyperreflexia, tremor.

Diagnosis[edit | edit source]

Diagnosis of serotonin syndrome is primarily clinical, based on patient history and symptoms. The Hunter Serotonin Toxicity Criteria, which focus on the presence of spontaneous clonus, inducible clonus, ocular clonus, tremor, hyperreflexia, hypertonia, temperature, agitation, and diaphoresis, are commonly used to diagnose the condition.

Treatment[edit | edit source]

Immediate treatment of serotonin syndrome involves discontinuation of all serotonergic agents and supportive care to normalize body temperature and stabilize vital signs. In more severe cases, hospitalization may be required. Medications such as cyproheptadine, a serotonin antagonist, can be used to block serotonin effects.

Prevention[edit | edit source]

Prevention of serotonin syndrome involves careful management of all medications that affect serotonin levels. This includes avoiding the concurrent use of multiple serotonergic drugs and careful monitoring when changing dosages or adding new medications.

See also[edit | edit source]


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Contributors: Prab R. Tumpati, MD