The Serotonin Syndrome

  title={The Serotonin Syndrome},
  author={Karl A. Sporer},
  journal={Drug Safety},
  • K. Sporer
  • Published 1 August 1995
  • Medicine, Biology
  • Drug Safety
SummaryThe serotonin syndrome has increasingly been recognised in patients who have received combined serotonergic drugs. This syndrome is characterised by a constellation of symptoms (confusion, fever, shivering, diaphoresis, ataxia, hyperreflexia, myoclonus or diarrhoea) in the setting of the recent addition of a serotonergic agent.The most common drug combinations causing the serotonin syndrome are monoamine oxidase inhibitors (MAOIs) and serotonin selective reuptake inhibitors (SSRIs… 

Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions

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.

Serotonin Syndrome—What Have We Learned?

Antidepressants and the serotonin syndrome in general practice.

  • F. J. MackayN. DunnR. Mann
  • Medicine, Psychology
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1999
Improved awareness of the serotonin syndrome is needed within general practice, and there is a need to distinguish the relatively minor serotonergic symptoms from those of a severe, life-threatening serotonin syndrome.

The serotonin syndrome

Two cases of the serotonin syndrome are described where the diagnosis was not immediately apparent, and the pathophysiology, clinical course and treatment are then discussed.

The serotonin syndrome and its treatment

  • P. Gillman
  • Medicine, Psychology
    Journal of psychopharmacology
  • 1999
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.

Possible serotonin syndrome in association with 5-HT(3) antagonist agents.

The authors report the probable occurrence of the serotonin syndrome with serotonin receptor subtype 3 (5-HT(3)) antagonist therapy when used to control nausea associated with chemotherapy in two seriously ill children.

Sumatriptan Contraindications and the Serotonin Syndrome

It is suggested that sumatriptan should continue to be avoided in patients taking these agents until further data demonstrating safety become available, and the balance of documented clinical experience suggests that most patients tolerate this combination without incident.

Nausea and Vomiting Associated With Selective Serotonin Reuptake Inhibitors

The most effective drug for the treatment of SSRI-related adverse effects on the GIT is ondansetron, a serotonin 5-HT3 receptor antagonist that blocks the effects of serotonin in the brain and GIT, however, this drug has a high acquisition cost.

Serotonin Syndrome Presentation of 2 Cases and Review of the Literature

It was found that patients with serotonin syndrome most often presented within 24 hours of medication initiation, overdose, or change in dosage, and most patients had complete resolution of their symptoms within 24Hours of presentation.



Serotonin Syndrome

The serotonin syndrome provides a heuristic model of the putative mode of action of antidepressants and provides the physical and objective expression of an antidepressant-induced increase in serotonin neurotransmission.

The serotonin syndrome.

  • H. Sternbach
  • Medicine, Psychology
    The American journal of psychiatry
  • 1991
The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment, and further work is needed to establish the diagnostic criteria, incidence, and predisposing factors.

Ecstasy, the serotonin syndrome, and neuroleptic malignant syndrome--a possible link?

The report of toxic reactions to the designer drug, ecstasy, in Ms Randall's report bears a striking resemblance to the serotonin syndrome reported in psychiatric patients, which is characterized by some or all of the following symptoms.

Serotonin syndrome caused by a moclobemide-clomipramine interaction.

A 7T year old woman with depression and Parkinson's disease has a case of serotonin syndrome induced by the reversible monoamine oxidase A inhibitor moclobemide and the serotonin reuptake inhibitor clomipramine, and fulfilled the diagnostic criteria for the serotonin syndrome suggested by Sternbach.

Serotonin Syndrome: A Case Report

A child with suprasellar region tumor who presented with depression and obsessive-compulsive disorder and received a combination of sertaline (se-lective serotonin reuptake inhibitor) and clomipramine (tricyclic antidepressant) experienced symptoms of serotonin syndrome, which occurred within 24 hours after increasing the dose of sERTaline.

Sertraline-Phenelzine Drug Interaction: A Serotonin Syndrome Reaction

Selective serotonin reuptake inhibitor antidepressants should not be combined with monoamine oxidase inhibitor antidepressants because of the risk of serotonin syndrome.

Possible monoamine oxidase inhibitor-serotonin uptake inhibitor interaction: fluoxetine clinical data and preclinical findings.

Data reviewed reinforce the idea that the administration of an MAOI in close temporal proximity to fluoxetine is contraindicated, and suggest a possible role of serotonin and/or serotonin-dopamine interactions in the hypermetabolic state that may occur when a serotonin uptake inhibitor and anMAOI are coadministered, although alternative etiologic processes are possible as well.

Adverse consequences of fluoxetine-MAOI combination therapy.

The authors describe two series of patients: 12 treated simultaneously with fluoxetine and a monoamine oxidase inhibitor and 6 patients started on treatment with an MAOI 10 days or more after

The serotonin syndrome in a patient receiving sertraline after an ankle block.

A case of prolonged myoclonus in a patient who underwent a minor orthopedic procedure under an ankle regional anesthetic block and sedation and who was taking sertraline for depression is reported and it is proposed that she exhibited the serotonin syndrome, a disorder of 5-HT hyperstimulation, most commonly associated with serotonergic drugs.