Serotonin Syndrome
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Serotonin Syndrome

Serotonin Syndrome is a reaction produced by the body as a direct result of having an overabundance of serotonin (Pubmed). Often times, Serotonin Syndrome occurs when combining two or more medications known to increase the levels of serotnin in the body. Most people are able to regulate this inbalance, however, rarely symptoms present themselves. Often, these symptoms are mild and overlooked:

When diagnosed with many mental illnesses doctors and psychiatrists often prescribe drugs to increase serotonin levels. Serotonin is often referred to as one of the feel-good neurotransmiters in the brain. It is theorized that many people with depression, bipolar disorder, schizophrenia, and other illnesses have an inbalance of serotonin (along with other neurotransmitters) in the brain. However, when these drugs are prescribed doctors often leave out information about a rare but serious side effect known as Serotonin Syndrome. Serotonin Syndrome is a reaction produced by the body as a direct result of having an overabundance of serotonin (Pubmed).

Often times, Serotonin Syndrome occurs when combining two or more medications known to increase the levels of serotnin in the body. Most people are able to regulate this inbalance, however, rarely symptoms present themselves. Often, these symptoms are mild and overlooked:

  • Agitation or restlessness
  • Confusion
  • Rapid heart rate and high blood pressure
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles
  • Heavy sweating
  • Diarrhea
  • Headache
  • Shivering
  • Goose bumps

Serotonin sydrome can become life threatening if not caught early enough to remove the patient from the medication therapy. Symptoms of severe serotonin syndrom include seizures, irregular heartbeat, high fever, and loss of consciousness. Symptoms may present themselves mildly, and progressively. They can often come on so suddenly the patient and caregivers around them are confused and forget that they are taking medications that could be newly prescribed. If it is determined a patient is suffering from serotonin syndrome immediate hospitalization is required. Treatment includes using anti-anxiety medications as well as drugs to block the production and transmission of serotonin in the body. Once treatment has resolved the issue, doctors can continue to prescribe medications that increase serotonin in the body, but will closely monitor the patients progress.

Here is a list of drugs known to change the levels of serotonin in the body (Mayo Clinic)

  • Selective serotonin reuptake inhibitors: Celexa, Prozac, Zoloft
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), trazodone, Effexor
  • Tricyclic antidepressants, such as amitriptyline and nortriptyline
  • Monoamine oxidase inhibitors (MAOIs), Marplan, Nardil
  • Anti-migraine medications Axert, Amerge, Imitrex, carbamazepine
  • Pain medications  Flexeril, fentanyl Duragesic, Demerol and tramadol
  • Lithium  a mood stabilizer
  • Illicit drugs, including LSD, Ecstasy, cocaine and amphetamines
  • Herbal supplements, including St. John's wort and ginseng
  • Over-the-counter cough and cold medications containing dextromethorphan )
  • Anti-nausea medications metoclopramide Reglan,  Zofran)
  • Ritonavir (Norvir), an anti-retroviral medication used to treat HIV/AIDS

Sources:

PubMed

Mayo Clinic

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