A Review of Serotonin Toxicity Data: Implications for the Mechanisms of Antidepressant Drug Action

@article{Gillman2006ARO,
  title={A Review of Serotonin Toxicity Data: Implications for the Mechanisms of Antidepressant Drug Action},
  author={P. Ken Gillman},
  journal={Biological Psychiatry},
  year={2006},
  volume={59},
  pages={1046-1051}
}
  • P. Gillman
  • Published 2006
  • Psychology, Medicine
  • Biological Psychiatry
Data now exist from which an accurate definition for serotonin toxicity (ST), or serotonin syndrome, has been developed; this has also lead to precise, validated decision rules for diagnosis. The spectrum concept formulates ST as a continuum of serotonergic effects, mediated by the degree of elevation of intrasynaptic serotonin. This progresses from side effects through to toxicity; the concept emphasizes that it is a form of poisoning, not an idiosyncratic reaction. Observations of the degree… Expand
Drug-induced serotonin syndrome: a review
TLDR
The awareness of ST is crucial not only in avoiding the unintentional lethal combination of therapeutic drugs but also in recognizing the clinical picture when it occurs so that treatment can be promptly initiated. Expand
Extracting value from case reports: lessons from serotonin toxicity
Serotonin toxicity (ST) is an iatrogenic drug-induced ‘toxidrome’ displaying the characteristics expected of a synaptic serotonin concentration-related phenomenon. The term ST is preferable becauseExpand
Serotonin Syndrome Following Single Ingestion of High Dose Methamphetamine
Serotonin syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, overdose of particular drugs, or theExpand
Opioid analgesic drugs and serotonin toxicity (syndrome): mechanisms, animal models, and links to clinical effects
  • B. Baldo
  • Medicine
  • Archives of Toxicology
  • 2018
TLDR
Although the opioids most often associated with serotonin toxicity in humans inhibit human SERT in vitro, fentanyl and oxycodone are not inhibitory even though their clinical involvement has been reported, suggesting some SERT-independent effects on the serotonin system in vivo. Expand
Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions
TLDR
Whether the inhibition of tryptophan hydroxylase (TPH) may provide an opportunity to pharmacologically target central 5-HT synthesis, and so develop new treatments for severe, life-threatening SS is discussed. Expand
Update on recent serotonin toxicity publications including comment on , ‘ Conundrums in neurology : Diagnosing serotonin syndrome – a meta-analysis of cases ’ Au :
In the last decade experimental pharmacology, animal models, in vitro HCR receptor assays, in silico computer modelling, and detailed prospective studies in clinical toxicology, have all provided aExpand
University of Birmingham Serotonin syndrome
Serotonin syndrome (SS) (also referred to as serotonin toxicity) is a potentially life-threatening drug-induced toxidrome associated with increased serotonergic activity in both the peripheral (PNS)Expand
Triptans, serotonin agonists, and serotonin syndrome (serotonin toxicity): a review.
TLDR
There is neither significant clinical evidence, nor theoretical reason, to entertain speculation about serious SS from triptans and SSRIs, and the experimental foundation underpinning the latest understanding of SS is reviewed. Expand
Can 5-HT3 Antagonists Really Contribute to Serotonin Toxicity? A Call for Clarity and Pharmacological Law and Order
TLDR
This commentary aims to clarify misconceptions in order to aid clinical decision making when using 5-HT3 antagonists, which are unlikely to cause ST. Expand
Perspectives on genetic animal models of serotonin toxicity
TLDR
Current problems and perspectives regarding genetic animal models of serotonin-related syndromes are discussed, and the potential utility of these models in experimental neurochemistry and clinical research is outlined. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 86 REFERENCES
Amitriptyline: dual-action antidepressant?
  • P. Gillman
  • Medicine
  • The Journal of clinical psychiatry
  • 2003
TLDR
It may still be that amitriptyline has significant effects on serotonin when treating depression, but substantive evidence needs to be adduced for such a notion to remain convincing, or even sustainable. Expand
Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity.
  • P. Gillman
  • Medicine
  • British journal of anaesthesia
  • 2005
TLDR
Knowledge of the properties of these drugs will help to ensure that problems can be avoided in most clinical situations, and treated appropriately (with 5-HT(2A) antagonists for severe cases) if they occur. Expand
Serotonin syndrome: history and risk
  • P. Gillman
  • Medicine
  • Fundamental & clinical pharmacology
  • 1998
TLDR
It is proposed that more systematic national collection of toxicity data is essential in order to quantify the relative risk of serotonin syndrome with various combinations of serotonergic drugs. Expand
The serotonin syndrome and its treatment
  • P. Gillman
  • Medicine, Psychology
  • Journal of psychopharmacology
  • 1999
TLDR
There is some evidence suggesting the efficacy of chlorpromazine and cyproheptadine in the treatment of serotonin syndrome, but the evidence for cypro heptamines is less substantial than that for chlor Promazine, perhaps because the dose necessary to ensure blockade of brain 5-HT2receptors is higher than that used in the cases reported to date. Expand
Olanzapine and serotonin toxicity
TLDR
It is quite possible, and indeed likely, that the features described by Haslett and Kumar are due to a SSRI withdrawal syndrome, and these features are consistent with those described in other cases of SSRIs withdrawal. Expand
Possible neurobiological mechanisms underlying faster onset of antidepressant action.
  • P. Blier
  • Medicine
  • The Journal of clinical psychiatry
  • 2001
TLDR
Based on the effects of antidepressant drugs presently available, strategies to accelerate or augment the antidepressant response are described, some of which have already been examined in patients. Expand
Relative Toxicity of Selective Serotonin Reuptake Inhibitors (SSRIs) in Overdose
TLDR
This study shows SSRIs are relatively safe in overdose despite serotonin syndrome being common, and believes that cardiac monitoring should be considered in citalopram overdose, particularly with large ingestions and patients with associated cardiac disease. Expand
The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity.
TLDR
Decision rules (the Hunter Serotonin Toxicity Criteria) were developed that were simpler, more sensitive to serotonin toxicity and less likely to yield false positives. Expand
Adverse reactions to mirtazapine are unlikely to be serotonin toxicity.
TLDR
It is unclear what the human clinical correlates of this animal behavioral syndrome are, but they are not consistent with what is seen in human serotonin toxicity and there is no rationale for the synonymous use of the term “serotonin syndrome” for the clinical toxicity occurring in humans and this behavioral syndrome seen in rodents. Expand
New developments in the treatment of depression.
  • S. Montgomery
  • Medicine, Psychology
  • The Journal of clinical psychiatry
  • 1999
TLDR
These studies clearly suggest that the latest generation of antidepressants offer a more rapid response to treatment, an improved response rate, and superior long-term efficacy than conventional therapy. Expand
...
1
2
3
4
5
...