What is serotonin syndrome (SS)?
SS or better serotonin toxicity is a consequence of the buildup of serotonin in the synaptic cleft leading to an overstimulation of both peripheral and central postsynaptic serotonin receptors, 5HT-2A receptors being the most important ones. This results in a number of different and possibly life threatening symptoms. So if you think you or a friend suffers from SS call an ambulance now!
What causes SS?
Serotonin syndrome can occur via the therapeutic use of serotonergic drugs alone, an overdose of serotonergic drugs, or classically, as a result of a complex drug interaction between two serotonergic drugs that work by different mechanisms. A multitude of drug combinations can result in serotonin syndrome.
What are the symptoms?
The symptoms of serotonin syndrome usually present within 6 to 8 hours and most likely within 24 of overdosing or combining serotonergic drugs and can be barely noticeable to fatal.
Autonomic effects include:
- Nausea
- Diarrhea (with hyperactive bowel sounds)
- Headache
- Sweating
- Shivering
- Tachycardia
- Rise in blood pressure
- Rapid breathing
- High pulse
- Mydriasis
Somatic effects include:
- Muscle twitching
- Tremor
- Hyperreflexia
- Akathisia
- Ocular clonus (slow continuous lateral eye movement)
- Increased muscle tone (lower limb>upper limb)
Cognitive effects include:
- Confusion
- Hallucination
- Agitation
- Restlessness
- Anxiety
- Delirium
- Coma