Serotonin Syndrome Symptoms – Serotonin is a chemical messenger produced by nerve cells that transmit signals between them. Much of the body’s serotonin can found in the digestive system, but it is also found in blood platelets and present through the central nervous system (CNS).
Serotonin is produced from tryptophan, an amino acid that is received in a person’s diet and is found in certain foods such as cheese, nuts, and red meat. A deficiency in tryptophan can result in lower serotonin levels and contribute to mood disorders such as depression and anxiety.
What Does Serotonin Do?
Serotonin is the creation of a chemical conversion process that includes tryptophan, a component of proteins, and tryptophan hydroxylase, a chemical reactor. When combined, they form 5-hydroxytryptamine (5-HT), also known as serotonin.
Serotonin cannot penetrate the blood-brain barrier, so any serotonin that is found inside the brain must be produced inside the brain.
Serotonin is believed to play a role in mood, social behavior, appetite, digestion, memory, sleep, and sexual desire and function. Drugs that modify serotonin levels are used in the treatment of depression, nausea, and migraines, and may be beneficial for obesity and Parkinson’s disease.
In general, serotonin appears to significantly impact the CNS and general bodily functions, especially the gastrointestinal (GI) tract. Studies have found an association between serotonin and bone metabolism, breast milk production, liver regeneration, and cell division.
What is Serotonin Syndrome? What Causes It?
Serotonin syndrome can occur when a person increases a drug dose or uses a combination of drugs that cause serotonin to accumulate in the body at higher levels than the system can reasonably accommodate.
Any drug that increases serotonin in the brain, whether illicit or legal, can contribute to serotonin syndrome.
Too much serotonin can result in symptoms that range from mild (shivering and diarrhea) to severe (fever and seizures). Severe serotonin syndrome can be life-threatening if it goes untreated.
Mild forms of serotonin syndrome may dissipate within a day or so of halting use of an involved substance, or through the administration of drugs that block serotonin.
Serotonin Syndrome Symptoms
Symptoms of serotonin syndrome typically manifest with a few hours of using a new substance or increasing the dose of one already being used.
Signs and symptoms include:
- Agitation or restlessness
- Confusion
- Rapid heart rate
- High blood pressure (hypertension)
- Dilated pupils
- Loss of muscle coordination or twitching muscles
- Muscle rigidity
- Diarrhea
- Headache
- Shivering
Severe serotonin syndrome can be life-threatening. Signs and symptoms include:
- High fever
- Seizures
- Irregular heartbeat
- Unconsciousness
If you or someone you know has the above symptoms after increasing the dose of a substance or taking a new substance that raises serotonin levels please call 911 immediately.
Which Drugs Can Cause Serotonin Syndrome Symptoms?
Serotonin syndrome most often occurs when two medicines that increase the body’s level of serotonin are taken together in combination.
For example, you can develop this syndrome if you take migraine medicines called triptans in conjunction with antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
Prescription, over-the-counter, and illicit drugs that can increase serotonin levels alone or in conjunction with others and cause serotonin syndrome include:
- Serotonin reuptake inhibitors (SSRIs), antidepressants that include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants such as desvenlafaxine (Khedezla), desvenlafaxine succinate (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
- Monoamine oxidase inhibitors (MAOIs), antidepressants that include isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and transdermal selegiline (EMSAM)
- Antidepressants that affect multiple serotonin receptors
- Buspirone (BuSpar), a drug used for the treatment of anxiety disorders
- Desyrel ( Trazodone ), a drug prescribed for the treatment of depression or insomnia
- Migraine treatments
- Dextromethorphan, a cough suppressant found in many over-the-counter and prescription cough and cold medicines
- Certain painkillers, including fentanyl (Sublimaze, Fentora), fentanyl citrate (Actiq), meperidine (Demerol), pentazocine (Talwin), and tramadol (Ultram)
- Certain medications prescribed for the treatment of nausea
- Drugs of abuse, such as ecstasy, LSD, cocaine, and amphetamines
Treatment for Serotonin Syndrome
Treatment depends on the severity of serotonin syndrome symptoms:
- If your symptoms are minor, making a visit to the doctor and stopping the medication causing the condition may be enough.
- If you have symptoms that concern your doctor, you may need to visit a hospital.
- If you have severe serotonin syndrome, you will require intensive treatment in a hospital.
If you have engaged in drug abuse including any of the following, you may need treatment for addiction to a substance:
- You have increased the dose of a prescription drug without your doctor’s permission.
- You are abusing more than one serotonin-boosting medication without a doctor’s order.
- You are using an illicit drug(s) in combination with prescription medications.
- You have experienced serotonin syndrome as a result of the abuse or misuse of prescription or illicit drugs.