Serotonin syndrome. Find out what it is, what its symptoms are and how is it treated?

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Serotonin Syndrome is a condition caused by an excess of serotonin in the body. It belongs to the group of drug-induced syndromes – it can occur in people who take specific medications or drugs. Serotonin is a chemical responsible for many processes in the body; it is essential for the proper functioning of the nervous and circulatory systems, regulates the digestive system and, above all, has a strong influence on mood and behavior. However, it is difficult to determine how common the disease is, as many cases are certainly undetected; Estimates suggest that serotonin syndrome affects approximately 15 percent of patients who have overdosed on SSRIs (drugs from the group of serotonin reuptake inhibitors). Detecting this disease is made difficult because no test has yet been developed that could conclusively determine the serotonin syndrome.

The causes of serotonin syndrome

The underlying cause serotonin syndrome there is an excess of serotonin in the body. When serotonin receptors are overstimulated by this substance, the body can develop serotonin syndrome.

What can trigger such elevated levels serotonin? These are mainly the SSRIs mentioned, eg sertraline and fluoxetine; in addition to the most commonly guilty SSRIs, some drugs also increase serotonin levels – mainly LSD, amphetamines, cocaine and ecstasy. Serotonin syndrome it can also occur on its own in newborns, if the mother took any of the substances that increase serotonin levels during pregnancy. Serotonin and norepinephrine reuptake inhibitors, or SNRI drugs, may also be responsible for this disease. Although it can rightly be considered that this ailment is a threat to people taking psychotropic drugs, it should be remembered that it can occur due to an overdose of drugs from completely different groups, such as painkillers (e.g. pethidine, fentanyl), antiemetics (e.g. . metoclopramide, ondansetron) and even antitussives (including dextromethorphan).

Symptoms of serotonin syndrome

Z serotonin syndrome involve numerous symptoms, which can be divided into three groups: symptoms somatic (concerning the body), symptoms mental and symptoms autonomous system. Down symptoms somatic include neuromuscular dysfunction (e.g. myoclonic movements, muscle stiffness, tremors, muscle spasms), metabolic acidosis, renal failure, convulsions, breakdown of muscle cells (rhabdomyolysis) and disseminated intravascular coagulation syndrome. symptoms mental serotonin syndrome it is mainly restlessness, hallucinations, agitation, hypomania and, in extreme cases, coma. Among symptoms of the autonomic nervous system are primarily high fever, even leading to hyperpyrexia (a state in which the body temperature exceeds 41 degrees Celsius), increased blood pressure, diarrhea, nausea, tachycardia, chills, increased sweating and vomiting.

Treatment of serotonin syndrome

The basis of treatment serotonin syndrome it is based primarily on the discontinuation of the drugs responsible for it; in milder cases, when the disease is detected early, this alone can bring improvement and fix the problem. If the disease is in more advanced stage, cyproheptadine is often used, which substance is a serotonin receptor antagonist. It is essential too symptomatic treatment; drugs that lower blood pressure and fight tachycardia are often prescribed. It is especially important to combat high fever, which can even be life-threatening. Here, counter-intuitive, only cold compresses and medications that reduce muscle tension can help – antipyretic drugs are completely ineffective in this situation. Prognosis they are usually good – the disease is actually only dangerous if it is not treated; mortality serotonin syndrome in properly treated people, it is less than 1 percent. Therapy can also be very short because symptoms as soon as they can appear, they also disappear quickly and often – in some cases, even within a day.

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