Serotonin Syndrome
Posted: Monday, October 11th, 2021 | Updated: Monday, October 11th, 2021
Posted: Monday, October 11th, 2021 | Updated: Monday, October 11th, 2021
A Review of Serotonin Syndrome
Serotonin syndrome may result from an overdose in substances that increase free levels of serotonin, a neurotransmitter found in the body. Serotonin stimulates smooth muscle, plays a role in maintaining vascular tone, and promotes gastric motility. It also acts on the central nervous system helping to regulate sleep and mood. Substances that may lead to serotonin syndrome are antidepressants, profound stimulants, and certain opioids. The treatment protocol is focused on the symptomatic and supportive approach. Muscle relaxants, sedatives, intravenous fluid therapy, active cooling, serotonin antagonists, antiemetics, and anticonvulsant medications may be useful during treatment. When treated, the duration of the symptoms may last anywhere from 24 to 72 hours
Serotonin syndrome may result from an overdose in substances that increase free levels of serotonin, a neurotransmitter found in the body. Serotonin stimulates smooth muscle, plays a role in maintaining vascular tone, and promotes gastric motility. It also acts on the central nervous system helping to regulate sleep and mood. Substances that may lead to serotonin syndrome are antidepressants, profound stimulants, and certain opioids. The treatment protocol is focused on the symptomatic and supportive approach. Muscle relaxants, sedatives, intravenous fluid therapy, active cooling, serotonin antagonists, antiemetics, and anticonvulsant medications may be useful during treatment. When treated, the duration of the symptoms may last anywhere from 24 to 72 hours
Signs of serotonin syndrome may include:
Agitation or restlessness
Vomiting
Mydriasis
Tachycardia
Hypertension
|
Vocalization
Muscular contractions or rigidity
Diarrhea
Hypersalivation
Tachypnea
|
Mental status alterations
Tremors or shivering
Incoordination
Fever
Seizures
|
Medications that may lead to serotonin syndrome:
Low Serotonergic Potential
Amantadine (Antiviral/NMDA Antagonist)
Bupropion (Antidepressant)
Codeine (Opioid/Antitussive)
Fentanyl (Opioid)
Melatonin (Hormone/Nutraceutical)
Metoclopramide (GI Prokinetic/Antiemetic)
Mirtazepine (5-HT3 Receptor Antagonist/Tetracyclic Antidepressant)
Ondansetron (5-HT3 Receptor Antagonist)
Tramadol (Opioid)
|
Medium Serotonergic Potential
Buspirone (Anxiolytic)
Cocaine (Stimulant)
Doxepin (Antidepressant/Antihistamine)
LSD (Psychedelic)
S-Adenosyl-Methionine (Hepatoprotectant)
St. John’s Wort (Antidepressant)
Trazodone (Serotonin, 5-HT2A, Antagonist/Reuptake Inhibitor)
|
High Serotonergic Potential
5-hydroxytryptohan (Antidepressant)
Amitriptyline (Antidepressant/Antipruritic/Neuropathic Pain Modifier)
Clomipramine (Antidepressant)
Dextromethorphan (NMDA Antagonist)
Fluoxetine (Selective Serotonin Reuptake Inhibitor)
Meperidine (Opioid)
Paroxetine (Selective Serotonin Reuptake Inhibitor)
Selegiline (Monoamine Oxidase Inhibitor)
Sertraline (Selective Serotonin Reuptake Inhibitor)
Venlafaxine (Antidepressant)
|
Sources:
Colon, Cristina Aponte. "Serotonin Syndrome." Iowa Veterinary Specialties. https://www.iowaveterinaryspecialties.com/student-scholars/serotonin-syndrome.
Kahn, Cynthia M. The Merck/Merial Manual for Pet Health. Home Ed. Merck & Co., Inc. 2007.
Loftin, Erica. "Serotonin Syndrome." DoveLewis. https://www.atdove.org/article/serotonin-syndrome.
Plumb's. Vers. 2021.9.3. Educational Concepts, LLC. Google Play, https://play.google.com/store/apps/details?id=com.plumbs.app.
Colon, Cristina Aponte. "Serotonin Syndrome." Iowa Veterinary Specialties. https://www.iowaveterinaryspecialties.com/student-scholars/serotonin-syndrome.
Kahn, Cynthia M. The Merck/Merial Manual for Pet Health. Home Ed. Merck & Co., Inc. 2007.
Loftin, Erica. "Serotonin Syndrome." DoveLewis. https://www.atdove.org/article/serotonin-syndrome.
Plumb's. Vers. 2021.9.3. Educational Concepts, LLC. Google Play, https://play.google.com/store/apps/details?id=com.plumbs.app.