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Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the body. Serotonin is a neurotransmitter that regulates mood, appetite, and other bodily functions. Serotonin syndrome usually occurs as a result of taking medications that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or certain opioid pain medications.
Symptoms of serotonin syndrome may include:
Serotonin syndrome can be a medical emergency and requires prompt treatment. Treatment typically involves discontinuing the medication that is causing the symptoms, along with supportive care to manage symptoms. In severe cases, hospitalization and intensive care may be required. It is important to seek medical attention immediately if you or a loved one is experiencing symptoms of serotonin syndrome, particularly if taking medications that increase serotonin levels.
Excessive accumulation of serotonin in the body creates the symptoms of serotonin syndrome.
Typically, nerve cells in the brain and spinal cord produce serotonin that helps regulate attention, behavior and body temperature.
Other nerve cells in the body, primarily in the intestines, also produce serotonin. Serotonin plays a role in regulating the digestive process, blood flow and breathing.
Although it's possible that taking just one drug that increases serotonin levels can cause serotonin syndrome in some people, this condition occurs most often when people combine certain medications.
For example, serotonin syndrome may occur if you take an antidepressant with a migraine medication. It may also occur if you take an antidepressant with an opioid pain medication.
Another cause of serotonin syndrome is intentional overdose of antidepressant medications.
A number of over-the-counter and prescription drugs may be associated with serotonin syndrome, especially antidepressants. Illicit drugs and dietary supplements also may be associated with the condition.
The drugs and supplements that could potentially cause serotonin syndrome include:
Taking more than one serotonin-related medication or increasing your dose of a serotonin-related medication increases your risk of serotonin syndrome. Know what medications you take and share a complete list of your medications with your doctor or pharmacist.
Be sure to talk to your doctor if you or a family member has experienced symptoms after taking a medication.
Also talk to your doctor about possible risks. Don't stop taking any medications on your own. If your doctor prescribes a new medication, make sure he or she knows about all the other medications you're taking, especially if you receive prescriptions from more than one doctor.
If you and your doctor decide the benefits of combining certain serotonin-level-affecting drugs outweigh the risks, be alert to the possibility of serotonin syndrome.
Treatment of serotonin syndrome depends on the severity of your symptoms.
Depending on your symptoms, you may receive the following treatments:
Milder forms of serotonin syndrome usually go away within 24 to 72 hours of stopping medications that increase serotonin. You may need to take medications to block the effects of serotonin already in your system.
However, symptoms of serotonin syndrome caused by some antidepressants could take several weeks to go away completely. These medications remain in your system longer than do other medications that can cause serotonin syndrome.