What is Serotonin Syndrome

I think before knowing the answer to this question, you must know what is serotonin! Serotonin is a chemical or a neurotransmitter which helps in transmitting the essential signals from one area of the brain to another. This chemical is manufactured in the brain with the help of a biochemical process which uses protein blocks like tryptophan, hydroxylase, and tryptophan for the production purposes. Though this chemical is produced in the brain, it is also found in blood platelets, digestive tract and the pineal gland of the human body. Also known as the 5-hydroxytryptamine, this chemical is responsible for many functions in the human body like controlling mood related disorders, sexual desires, appetite, sleeping pattern, and learning abilities. The condition wherein the levels of serotonin in the body rise to abnormal levels due to consumption and/or increase in the dosage of certain medications and drugs, is known as serotonin syndrome.

A person may suffer from serotonin syndrome because of consuming certain supplements or illicit drugs as well. This may lead to improper functioning in the brain cells causing various unhealthy signs and symptoms like fever, shivering etc. The point to be noted is that if these symptoms go unnoticed, the condition can become extremely fatal and lead to death! However, with proper treatment and medication, serotonin syndrome can be treated effectively, bringing the situation under control.

Symptoms of Serotonin Syndrome

The symptoms are a result of the excessive presence of serotonin in the body which can cause psychological, physiological, and/or somatic illness in a person. The severity of these symptoms vary depending upon the severity of the condition. A person suffering from mild serotonin syndrome may experience mild symptoms like sweating, shivering, twitching, etc. On the other hand, severe symptoms like high blood pressure, high fever and overactive reflexes may also occur. The most commonly observed symptoms of serotonin syndrome are mentioned as follows. These generally occur after several hours of consuming certain drugs and medications which either you are taking for the first time, or are taking in higher amounts than usual.

• Excessive sweating
• Restlessness
• Agitation
• Diarrhea
• Dilated pupils
• Confusion
• Twitching in the muscles
• Shivering
• Loss of muscle coordination
• Goose bumps
• Increased heart rate
• Increased blood pressure
• Headache
• Hyperreflexia
• Vomiting
• Hallucinations
• Nausea
• Coma
• Seizures
• Hypertension

What Causes Serotonin Syndrome

As mentioned earlier, the main cause of serotonin syndrome is the overdose of certain drugs, or a combination of two different drugs, which leads to high level of serotonin in the body. A classic example for the same would be consumption of antidepressants (SSRIs) with the medication for migraine known as triptans. Many people who take the overdose of antidepressants can also suffer from this syndrome. Mentioned below is a list of medications and drugs that are associated with serotonin syndrome.

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Bupropion, is used as an antidepressant as well as an medication for tobacco addiction.
• Monoamine Oxidase Inhibitors (MAOIs)
• Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
• Illicit drugs like LSD, cocaine, Ecstasy, etc.
• Herbal supplements used for depression and anxiety like St. John's wort, nutmeg, Syrian rue, ginseng, etc.
• Mood stabilizer like lithium
• Medications for migraine
• Medications used to treat nausea
• Over the counter medications for cough and cold which contain dextromethorphan.
• Consumption of opioids like pentazocine, pethidine, tramadol, buprenorphine, etc.

Treatment of Serotonin Syndrome

If you can relate to the aforementioned causes and symptoms, then you must get in touch with your health care specialist as soon as possible. However, there are no tests which can diagnose the condition, but your doctor will definitely be able to identify if your symptoms and the medications you consume can be the possible cause. You must be honest and tell your doctor about the drugs and medications you are consuming, along with the dosage. If your condition is mild, your doctor may simply reduce the dosage or restrict you from taking the medicine at all. On the other hand, if your symptoms are more severe, your doctor may have to admit you in the hospital and use various treatment options to bring your symptoms back to normal. Your doctor may choose from a variety of treatment options, depending upon your condition. These include -

• Withdrawal of medications that are responsible for the condition.
• Usage of serotonin production blocking agents.
• Medications and drugs to control high heart rate and blood pressure.
• Usage of oxygen masks to maintain normal oxygen levels in the body, along with intravenous (IV) fluids to treat symptoms like dehydration and fever.
• Doctors may also use muscle relaxants to relax the twitching of muscles, control agitation, and prevent muscle stiffness.

I am sure after understanding the condition briefly, you would be cautious when it comes to consumption of drugs like antidepressants, pain killers, or other drugs listed above that can cause this syndrome. It is always best to consult with your family doctor before taking a drug so that the risk of developing this condition can be avoided. Have a safe tomorrow!