Advertisement

Serotonin Syndrome

  • Paul Ellis Marik
Chapter

Abstract

Serotonin syndrome is characterized by the triad of neuromuscular hyperactivity, autonomic hyperactivity, and change in mental status.1,2 It is not an idiosyncratic drug reaction but is a predictable response to serotonin excess in the central nervous system (CNS). It can occur from an overdose, a drug interaction, or an adverse drug effect involving serotonergic agents. Most severe cases result from a drug combination, especially the combination of selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). It occurs in approximately 15% of patients with SSRI overdose. The death of an 18-year-old patient named Libby Zion in New York City more than 20 years ago, which resulted from the coadministration of meperidine and phenelzine, remains the most widely recognized and dramatic example of this preventable condition.3

Keywords

Selective Serotonin Reuptake Inhibitor Neuroleptic Malignant Syndrome Monoamine Oxidase Inhibitor Malignant Hyperthermia Serotonin Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352:1112–1120.PubMedCrossRefGoogle Scholar
  2. 2.
    Isbister GK, Buckley NA, Whyte IM. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust. 2007;187:361–365.PubMedGoogle Scholar
  3. 3.
    Asch DA, Parker RM. The Libby Zion case. One step forward or two steps backward? N Engl J Med. 1988;318:771–775.PubMedCrossRefGoogle Scholar
  4. 4.
    Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991;148:705–713.PubMedGoogle Scholar
  5. 5.
    Dunkley EJ, Isbister GK, Sibbritt D, et al. The hunter serotonin toxicity criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96:635–642.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineEastern Virginia Medical SchoolNorfolkUSA

Personalised recommendations