Serotonin is a chemical produced by the body that allows brain cells and other nervous system cells to interact with one another. Insufficient serotonin in the brain is thought to play a role in depression. Too much, however, can cause excessive nerve cell activity, triggering a potentially lethal collection of symptoms known as serotonin syndrome.
Serotonin Syndrome Symptoms: How Does Serotonin Syndrome Feel Like?
Serotonin syndrome symptoms often start within hours of taking a brand-new medication that affects serotonin levels or excessively increasing the dosage of one you are currently taking. Symptoms might include:
- Agitation or restlessness
- Dilated students
- Modifications in blood pressure and/or temperature
- Queasiness and/or vomiting
- Rapid heart rate
- Loss of muscle coordination or twitching muscles
- Shivering and goose bumps
- Heavy sweating
In severe cases, serotonin syndrome can be life threatening. If you experience any of these symptoms, you or somebody with you need to look for medical attention right away:
- High fever
- Irregular heart beat
Causes of Serotonin Syndrome
Serotonin syndrome can happen if you are taking medications, especially antidepressants that impact the body’s level of serotonin. The greatest risk of serotonin syndrome occurs if you are taking two or more drugs and/or supplements together that impact serotonin. The condition is more likely to take place when you first begin a medicine or increase the dosage.
The most typically prescribed class of antidepressants, which work by increasing serotonin, are the serotonin reuptake inhibitors (SSRIs). These include Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline).
Other prescription and non-prescription drugs that can raise serotonin levels alone or in combination to cause serotonin syndrome include:
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), a class of antidepressants including Cymbalta (duloxetine), Effexor (venlafaxine), Pristiq (desvenlafaxine) and Fetzima (levomilnacipran).
- Monoamine oxidase inhibitors (MAOIs), a class of antidepressants including Parnate (tranylcypromine), Marplan (isocarboxazid), Nardil (phenelzine) and Emsam (transdermal selegiline).
- Buspirone (Buspar), a substance abuse to treat stress and anxiety conditions.
- Trazodone (Desyrel), a drug prescribed for depression or sleeping disorders.
- Migraine treatments such as Axert (almotriptan), Amerge (naratriptan), Imitrex (sumatriptan), Maxalt (rizatriptan) and Zomig (zolmitriptan).
- Certain pain medications, consisting of Actiq, Fentora, Sublimaze (fentanyl), Demerol (meperidine), Talwin (pentazocine), and Ultram (tramadol).
- Dextromethorphan, a cough suppressant discovered in lots of over the counter and prescription cough medicines or cold medicines.
- Specific medications prescribed for queasiness, such as Kytril (granisetron), Reglan (metoclopramide), and Zofran (ondansetron).
- Unique antidepressants that impact numerous serotonin receptors, such as Viibryd or Trintellix (formerly Brintellix).
Some illegal drugs, such as LSD and drug, and dietary supplements, including St. John’s wort and ginseng, can likewise lead to serotonin syndrome when integrated with antidepressants that impact serotonin.
The FDA recently asked drug producers to consist of cautioning labels on their products to let patients understand about the potential risk of serotonin syndrome. If you are uncertain about drugs you take or have actually been recommended, examine the label or talk to your doctor. Don’t stop any medication before talking to your doctor.
Serotonin Syndrome Diagnosis
There is no single test to detect serotonin syndrome. Your healthcare service provider will inquire about your medical history, consisting of medication, supplement, and recreational drug use, and perform a physical examination. Other conditions may cause symptoms that resemble serotonin syndrome. Lab tests to exclude other causes of symptoms may be ordered.
Serotonin Syndrome Treatments
People with serotonin syndrome are typically hospitalized for observation and treatment of symptoms. For instance, benzodiazepines are provided to treat agitation and/or seizures. Intravenous fluids are given to preserve hydration. Getting rid of the drug accountable for the serotonin syndrome is crucial. Hydration by intravenous (IV) fluids) is likewise common. In severe cases, a medication called Periactin (cyproheptadine) that obstructs serotonin production might be used.
Hyperthermia can cause metabolic acidosis, rhabdomyolysis, intense kidney injury and shared intravascular coagulation. Thermal disruption ought to be aggressively managed. Any patient with a temperature over 40.5 ° C ought to be handled with:
- Paralysis and ventilation.
- Ice bath immersion/ice packs if not responsive (to avoid distributed intravascular coagulation and organ failure).
Antipyretic agents have no function, as hyperthermia is because of muscular activity instead of hypothalamic mechanisms. Chlorpromazine might be used to treat agitation and hyperthermia.
- Aspiration pneumonia.
- Respiratory failure.
Can You Die from Serotonin Syndrome?
If patients recuperate from an acute episode and avoid provoking representatives then the outlook readies. Many deaths happen within the first 24 hours.