Serotonin syndrome is caused by an excess of serotonin in the brain, which can be caused by medications, illicit drugs, and certain diseases. Symptoms range from mild to severe and can lead to death. Treatment involves stopping any contributing medications and possibly administering a serotonin-thumping drug. Those with risk factors should seek medical attention if they experience symptoms.
Serotonin syndrome occurs when there is too much of the neurotransmitter serotonin in the brain. The likelihood of recovery depends on the severity of the symptoms and how quickly treatment is sought. Medications, illicit drug use, and some diseases can cause excess serotonin to build up. Those with risk factors for serotonin syndrome should be aware of the symptoms and see their doctor if they notice anything abnormal.
The symptoms of serotonin syndrome can sometimes be so mild as to be barely noticeable and can be easily dismissed. Other people experience more obvious symptoms. They may notice their heart rate suddenly increases or they may start shaking or sweating. Dilated pupils, tremors, or intermittent twitching are also common symptoms of serotonin syndrome. People who experience symptoms of serotonin syndrome tend to feel confused, foggy, or may complain of headaches.
Those with moderate symptoms of serotonin syndrome may be restless, agitated, or anxiously hypervigilant. They may experience a hypomanic episode in which they talk very fast, have racing thoughts, and cannot calm down. High blood pressure may be detectable in patients with moderate symptoms. An increase in body temperature, up to 104° Fahrenheit (40° Celsius), is another symptom of moderate serotonin syndrome. Nausea, diarrhea, or an unstable stomach with very active bowel sounds are other indications of this condition.
Severe symptoms of serotonin syndrome can lead to death. Heart rate and blood pressure can increase to the point that the individual goes into shock or falls into a coma. Body temperature can rise up to 106° Fahrenheit (41.1° Celsius). Such high temperatures can cause brain damage and lead to hallucinations, metabolic acidosis, seizures, kidney failure, blood clotting problems or bleeding.
Certain over-the-counter, prescription, and illegal drugs known to increase serotonin levels in the brain may be causal factors in the development of serotonin syndrome symptoms. Those taking antidepressants, such as Paxil, Effexor and Wellbutrin, are often at risk of developing the syndrome. Herbal supplements, including ginseng and St. John’s Wort, are also known to increase serotonin levels. Certain thyroid conditions, such as alcohol or heroin withdrawal, can also cause serotonin syndrome.
Most people with serotonin syndrome make a full recovery. In mild cases, treatment is to avoid any medications that could be contributing to the condition. If you have moderate or severe serotonin poisoning, your doctor will likely stop any problem medications and then may give you a serotonin-thumping drug. The patient can also be sedated if agitated. People with risk factors for serotonin syndrome who think they are showing symptoms should see a doctor right away.
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