| Serotonin syndrome is a life-threatening drug reaction | | | | elevated serotonin levels. Another risk factor relates to |
| that causes the body to have too much serotonin, a | | | | drug metabolism rate. |
| chemical produced by nerve cells. It is an iatrogenic (i.e. | | | | Slow metabolizers of SSRIs (approximately 7% of the |
| caused by medical treatment) toxidrome. Serotonin | | | | population) may produce higher than normal levels of |
| syndrome is caused by increased serotonin in the | | | | these antidepressants in the blood. Serotonin |
| central nervous system. It is the result of | | | | syndrome can be life threatening. The most important |
| overstimulation of 5-HT1A receptors in central grey | | | | treatment is to discontinue the offending agent. |
| nuclei and the medulla and, perhaps, of overstimulation | | | | Benzodiazepines, such as diazepam (Valium) or |
| of 5-HT2 receptors. Serotonin syndrome is not a | | | | lorazepam (Ativan), can help control agitation, |
| spontaneous drug reaction, it is a consequence of | | | | seizure-like movements and muscle stiffness. |
| excess serotonergic activity at central nervous | | | | Moderate cases should have all thermal and |
| system (CNS) and peripheral serotonin receptors. | | | | cardiorespiratory abnormalities corrected and can |
| Serotonin syndrome can occur when you take certain | | | | benefit from serotonin antagonists (i.e. cyproheptadine). |
| combinations of prescription medications that affect | | | | Esmolol (Brevibloc) or nitroprusside (Nitropress) drugs |
| serotonin levels in your body. | | | | to reduce an increased heart rate or high blood |
| Signs and symptoms of serotonin syndrome range | | | | pressure. If other treatments aren't working |
| from restlessness and rapid heartbeat to muscle | | | | cyproheptadine (Periactin), a drug that blocks serotonin |
| rigidity and seizures. Severe case often have agitated | | | | production. |
| delirium as well as muscular rigidity and high muscular | | | | Serotonin Syndrome Treatment Tips |
| tension. Temperature may rise to above 41.1°C | | | | 1. Cyproheptadine (Periactin), a drug that blocks |
| (105.98°F) in life-threatening cases. Other | | | | serotonin production. |
| abnormalities include metabolic acidosis, | | | | 2. Lorazepam and diazepam have been shown to be |
| rhabdomyolysis, seizures, renal failure, and | | | | effective in treating serotonin syndrome. |
| disseminated intravascular coagulation. Risk factors for | | | | 3. Benzodiazepines, such as diazepam (Valium) or |
| the development of serotonin syndrome are unclear, | | | | lorazepam (Ativan), can help control agitation. |
| but some trends are becoming apparent as more | | | | 4. Rigidity, seizures, and agitation are treated with |
| cases appear in the literature. Peripheral vascular | | | | benzodiazepines. |
| disease and atherosclerosis may lead to severe | | | | 5. Esmolol or nitroprusside drugs to reduce an |
| vasospasm and hypertension in the presence of | | | | increased heart rate or high blood pressure. |