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Serotonin Syndrome

The Basics

Written by the doctors and editors at UpToDate пїЅ пїЅ

What is serotonin syndrome? " пїЅ Serotonin syndrome is a serious problem that can cause a number of symptoms, including: пїЅ пїЅ

  • Anxiety, restlessness, or confusion
  • Sweating
  • Muscle spasms and muscle rigidity
  • Rapid back and forth eye movements
  • Shaking or trembling
  • Fever
  • Rapid heart rate
  • Vomiting
  • Diarrhea

What causes serotonin syndrome? " пїЅ Serotonin syndrome happens to people after they take certain medicines or combinations of medicines. It can also happen with certain herbal products and street drugs. There are many medicines and drugs that can lead to serotonin syndrome. In general, they all affect a chemical in the brain and body called "serotonin. " пїЅ пїЅ пїЅ

Examples of the medicines and drugs that can cause serotonin syndrome include: пїЅ пїЅ

  • Antidepressants
  • Some pain relievers, such as meperidine (brand name: Demerol), tramadol (brand name: Ultram), and cyclobenzaprine (brand name: Flexeril)
  • Saint Johns wort (an herbal medicine used to treat depression)
  • Medicines used to treat migraine headaches, called "triptans " пїЅ
  • Street drugs, such as ecstasy, cocaine, and amphetamines

Doctors do not know why some people get serotonin syndrome and others do not. But they do know that people usually develop it within hours of taking a new medicine or drug, a new dose, or a new combination of medicines or drugs. пїЅ пїЅ

Should I see a doctor or nurse? " пїЅ If you have symptoms of serotonin syndrome, and you recently took a new drug or medicine or a new dose, call your doctor right away. If your symptoms are severe, go to the emergency room or call for an ambulance (in the US and Canada, dial 9-1-1). пїЅ пїЅ

Will I need tests? " пїЅ Maybe. There is no single test that can show whether or not you have serotonin syndrome. Still, some of the things the doctor will do during the exam can help him or her figure out if you have it. For instance, the doctor might test your leg muscles to see if they spasm. The doctor will also ask a lot of questions about any medicines, herbal products, or street drugs you might have taken. пїЅ пїЅ

If you have serotonin syndrome, it's very important that you be honest with your doctor about what you took, how much, and when. пїЅ пїЅ

How is serotonin syndrome treated? " пїЅ As part of treatment, the doctor will stop the medicines or drugs that caused the serotonin syndrome in the first place. He or she will also monitor your breathing, heart rate, blood pressure, and body temperature, and try to keep these as close to normal as possible. пїЅ пїЅ

Depending on what you need, he or she might also: пїЅ пїЅ

  • Give you medicines to calm you
  • Give you medicines to block the effects of serotonin
  • Work with you to decide whether you should keep taking the medicines that caused your serotonin syndrome

Can serotonin syndrome be prevented? " пїЅ No, but there are things you can do to protect yourself. пїЅ пїЅ

Doctors have no way to predict who will get serotonin syndrome, so it's not possible to prevent cases caused by properly prescribed medicines. Even so, there are things you can do to protect yourself from dangerous reactions to medicines: пїЅ пїЅ

  • Always tell any doctor who prescribes medicines for you about ALL the medicines, herbal products, and street drugs you take. That way, the doctor can be careful not to give you medicines that could cause problems when combined.
  • When starting a new medicine, have the pharmacist check for drug interactions and double-check that you are taking the right amount.
  • If you are already on medicine, do not take a new herbal or over-the-counter medicine without first checking with your doctor, nurse, or pharmacist.

All topics are updated as new evidence becomes available and our peer review process is complete. пїЅ пїЅ

This topic retrieved from UpToDate on: Nov 04, 2014. пїЅ пїЅ

Topic 87578 Version 3.0 пїЅ пїЅ

Release: 22.8 - C22.206 пїЅ пїЅ

пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ

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пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ