Serotonin syndrome

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Symptoms

By Mayo Clinic staff

Serotonin syndrome symptoms typically occur within several hours of taking a new drug or increasing the dose of a drug you're already taking. Signs and symptoms include:

  • Agitation or restlessness
  • Confusion
  • Rapid heart rate
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles
  • Heavy sweating
  • Diarrhea
  • Headache
  • Shivering
  • Goose bumps

Severe serotonin syndrome can be life-threatening. Signs and symptoms include:

  • High fever
  • Seizures
  • Irregular heartbeat
  • Unconsciousness
When to see a doctor
If you suspect you might have serotonin syndrome after starting a new drug or increasing the dose of a drug you're already taking, call your doctor right away or go to the emergency room. If you have severe or rapidly worsening symptoms, seek emergency treatment immediately.
References
  1. Moore DP. Serotonin syndrome. In: Moore DP. Moore & Jefferson: Handbook of Medical Psychiatry. 2nd ed. Philadelphia Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/113440701-3/0/1243/148.html#4-u1.0-B0-323-02911-6..50148-2_1373.  Accessed Dec. 10, 2008.
  2. Bilden EF, et al. Antidepressants. In: Marx JA: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia Pa.: Elsevier; 2006. http://www.mdconsult.com/das/book/body/113410207-5/0/1365/463.html#4-u1.0-B0-323-02845-4..50154-2--cesec45_7826. Accessed Dec. 10, 2008.
  3. Boyer EW, et al. Serotonin syndrome. New England Journal of Medicine. 2005;352:1112.
  4. Combined use of 5-hydroxytryptamine receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephrine reuptake inhibitors (SNRIs) may result in life-threatening serotonin syndrome. US Food and Drug Administration. http://www.fda.gov/Cder/Drug/advisory/SSRI_SS200607.htm. Accessed Dec. 10, 2008.
  5. Zeping H, et al. Herb-drug interactions. Drugs. 2005;65:1239.
  6. Chyka PA, et al. Dextromethorphan poisoning: An evidence-based consensus guideline for out-of-hospital management. Clinical Toxicology. 2007;45:662.
  7. Argwal P. Serotonin syndrome. In: Ferri's Clinical Advisor 2009. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/113440701-3/0/1701/541.html#4-u1.0-B978-0-323-04134-8..50022-7--subchapter15_11410. Accessed Dec. 10, 2008

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Feb. 7, 2009

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