What is Serotonin Syndrome?

Serotonin syndrome is a group of symptoms caused by taking serotoninergic drugs (such as chlorpromazine, fluoxetine, serotonin, etc.) or combining serotoninergic drugs and monoamine oxidase inhibitors. Typical clinical cases are rare. Its main clinical manifestations include: changes in mental state and behavior (hypomania, agitation, confusion, disorientation, stun state); changes in motor system functions (myoclonus, myotonia, tremor, hyperreflexia, ankle clonus, total Dysfunction); autonomic dysfunction (fever, nausea, diarrhea, headache, trembling, flushing, sweating, tachycardia, shortness of breath, changes in blood pressure, dilated pupils). ^[1]

Serotonin syndrome

Serotonin syndrome is a group of symptoms caused by taking serotoninergic drugs (such as chlorpromazine, fluoxetine, serotonin, etc.) or combining serotoninergic drugs and monoamine oxidase inhibitors. Typical clinical cases are rare. Its main clinical manifestations include: changes in mental state and behavior (hypomania, agitation, confusion, disorientation, stun state); changes in motor system functions (myoclonus, myotonia, tremor, hyperreflexia, ankle clonus, total Dysfunction); autonomic dysfunction (fever, nausea, diarrhea, headache, trembling, flushing, sweating, tachycardia, shortness of breath, changes in blood pressure, dilated pupils). ^[1]

Three characteristics of the syndrome are key to understanding the disease:

First, serotonin syndrome is not idiopathic

Serotonin syndrome is often described as a clinical triad including altered mental status, autonomic hyperfunction, and neuromuscular abnormalities, but not all three manifestations are consistent in all patients. The clinical manifestations of serotonin excess can range from mild cases of tremor and diarrhea to life-threatening cases.

Serotonin syndrome has a series of clinical manifestations. Mild patients may not have fever, but have

Serotonin is

No laboratory test can confirm the diagnosis of serotonin syndrome. When the patient is tremor, clonic, or unable to sit still without others

Serotonin syndrome is a selective 5-HT reuptake inhibitor (SSRIs),

Treatment of serotonin syndrome includes removing medications that induce disease, providing supportive care, controlling restlessness, using 5-HT2A antagonists, controlling autonomic disorders, and controlling fever. Many serotonin syndrome cases usually resolve within 24 hours after starting treatment and discontinuing serotoninergic drugs, but symptoms may persist if the patient has a long elimination half-life, active metabolites, or prolonged action. . by

Serotonin syndrome can be avoided by comprehensively adopting the following measures: pharmacogenetic research, physician training, adjustment of doctor's orders, and utilization of technological advances. Using pharmacogenomic principles may protect patients at risk of developing the syndrome from serotonergic drugs. Once a toxic reaction occurs, consult a pharmacologist, clinical pharmacology department, or poison control center to determine serotonin-promoting drugs and drug interactions, help clinicians predict adverse reactions, and provide valuable clinical decision-making experience. Avoiding multiple drugs is the key to preventing serotonin syndrome. However, if multiple medications are required, computerized drug classification systems and the use of personal digital assistants (PDAs) can detect drug interactions and can reduce reliance on memory to prescribe medication orders. Some have suggested linking postmarketing surveillance results to physician training to raise awareness of serotonin syndrome.