Serotonin is really a natural chemical (a naturally sourced brain chemical) that can help regulate mood and behavior, and growing serotonin is an excellent method of treating depression.
But when you are taking antidepressant medication that increases serotonin an excessive amount of, you may be in danger of a harmful drug reaction known as serotonin syndrome.
“Serotonin syndrome usually occurs when a physician prescribes a medication that increases serotonin to some patient already with an antidepressant,” stated Mark Su, MD, assistant professor of emergency medicine at Hofstra College and director from the Toxicology Fellowship at Northern Coast College Hospital in Manhasset, N.Y.
Drugs for Depression Increase Serotonin
Early reports of serotonin overload happened within the 1950s with antidepressants known as monoamine oxidase inhibitors (MAOIs). When new drugs known as selective serotonin reuptake inhibitors (SSRIs) grew to become broadly accustomed to fight depression, reports of serotonin syndrome elevated.
SSRIs include Prozac and Paxil. Other antidepressant drugs that increase serotonin are known as serotonin-norepinephrine reuptake inhibitors (SNRIs), including Cymbalta and Effexor.
Drugs That Create Serotonin Overload
“Just one antidepressant may cause serotonin syndrome if your patient overdoses around the drug. Another cause is beginning a brand new antidepressant before a classic antidepressant continues to be completely washed from the body,” stated Dr. Su.
“But the most typical cause is including another kind of drug. This could happen if your patient does not let a physician know they’re with an antidepressant or maybe a physician is unaware of the risk.” Some common add-on drugs that can lead to serotonin overload would be the discomfort medication meperidine (also known through the brand Demerol), the cough medication dextromethorphan, drugs known as triptans employed for migraine, and also the recreational drug ecstasy.
Serotonin Syndrome Signs and symptoms
Serotonin syndrome may cause a large spectrum of signs and symptoms because of overstimulation. Gastrointestinal signs and symptoms include diarrhea and vomiting. Central nervous system signs and symptoms include overactive reflexes and fits, stated Su.
Other serotonin syndrome signs and symptoms include high body’s temperature, sweating, shivering, clumsiness, tremors, and confusion along with other mental changes.
Signs and symptoms of serotonin syndrome can vary from mild to existence threatening. In extraordinary instances, body’s temperature may become high, muscles may break lower, and you might get into shock.
Serotonin Syndrome Details
A 2013 overview of serotonin syndrome printed within the journal AACN Advanced Critical Care noted the Toxic Exposure Surveillance System identified 26,733 installments of serotonin syndrome in 2002. Of individuals cases, 7,349 were considered moderate or severe, and 93 led to dying.
Just 2 yrs later, there have been 48,204 cases, 8,187 moderate or severe cases, and 103 deaths. The important thing to effective treatment methods are early recognition.
Diagnosing Serotonin Syndrome
“The easiest method to identify serotonin syndrome is as simple as taking past drug exposure and signs and symptoms of serotonin overload. Diagnostic tests don’t help, so doctors need to understand the twelve signs and signs and symptoms,” stated Su.
Based on the AACN Advanced Critical Care study, getting past going for a serotonin-raising drug and getting three from the major signs and symptoms or indications of serotonin syndrome are sufficient to help make the diagnosis. Bloodstream tests might be done to consider drugs that raise serotonin levels.
Serotonin Syndrome Treatment
Serotonin syndrome usually requires treatment inside a hospital. The initial step would be to stop any drugs that raise serotonin.
You might need medication to manage anxiety as well as reducing muscles spasms and perhaps a medication that blocks serotonin production, cyproheptadine.
“Cyproheptadine is just obtainable in dental form. Sometimes we have to crush it and provide it via a nasogastric tube. Cooling baths enables you to bring lower body’s temperature. Fluids, bloodstream pressure, and breathing support may be required for severe cases. Most sufferers be more effective within 48 hrs,” stated Su.
Stopping Serotonin Syndrome
The easiest method to prevent serotonin syndrome would be to let all your caregivers learn about all your medications before adding any brand new ones.
If you are on any drug that increases your serotonin level, seek advice from your physician before you take even an over-the-counter medication or supplement.
Besides ecstasy, recreational drugs associated with serotonin syndrome include LSD and bath salts.
“Understanding the danger and understanding the signs and symptoms will help both you and your caregivers avoid a harmful serotonin overload,” stated Su.