Serotonin Syndrome

Symptoms of Serotonin Overload

Serotonin syndrome can cause a wide spectrum of symptoms due to overstimulation. Gastrointestinal symptoms include diarrhea and vomiting. Nervous system symptoms include overactive reflexes and muscle spasms, said Su. Other signs and symptoms include high body temperature, sweating, shivering, clumsiness, tremors, and confusion and other mental changes.

Symptoms of serotonin syndrome can range from mild to life threatening. In extreme cases, body temperature can become very high, muscles may break down, and a person may go into shock.

Treating Serotonin Syndrome

Serotonin syndrome usually requires treatment in a hospital. The first step is to stop any drugs that raise serotonin. You may need medication to control anxiety and relieve muscles spasms and possibly a drug that blocks serotonin production, called cyproheptadine.

"Cyproheptadine is only available in oral form. Sometimes we need to crush it and give it through a nasogastric tube. Cooling baths may be used to bring down body temperature. Fluids, blood pressure, and breathing support may be needed for severe cases. Most patients are better within 48 hours," said Su.

Drugs That Cause Serotonin Overload

"A single antidepressant can cause serotonin syndrome if a patient overdoses on the drug. Another cause is starting a new antidepressant before an old antidepressant has been completely washed out of the body," said Dr. Su.

"But the most common cause is adding on another type of drug. This can happen if a patient doesn't let a doctor know they are on an antidepressant or if a doctor is not aware of the danger." Some common add-on drugs that could lead to serotonin overload are the pain medication meperidine (better known by the brand name Demerol), the cough medication dextromethorphan, drugs called triptans used for migraine, and the recreational drug ecstasy.

Serotonin syndrome is a dangerous depression drug reaction.

Serotonin is a brain chemical that helps regulate mood and behavior, andincreasing serotonin is one way of treating depression. But if you're taking depression medication that increases serotonin too much, you could be at risk for a dangerous drug reaction called serotonin syndrome.

"Serotonin syndrome usually happens when a doctor prescribes a drug that increases serotonin to a patient already on an antidepressant," said Mark Su, MD, assistant professor of emergency medicine at Hofstra University and director of the Toxicology Fellowship at North Shore University Hospital in Manhasset, N.Y.