Serotonin Syndrome

Abstract

Serotonin syndrome (SS) is a complication that occurs due to drug interactions that result in an increase in serotonin in the central nervous system. This syndrome is classically described as a triad of altered mental status, autonomic hyperactivity, and neuromuscular abnormalities that can be life threatening. As such, prompt detection is crucial so that treatment can be delivered to prevent long-term complications from hyperthermia, malignant hypertension, and/or cardiac arrhythmias. Determining the diagnosis can be difficult as several other conditions have similarities to SS; these include malignant hyperthermia, neuroleptic malignant syndrome, and anticholinergic toxicity. If appropriately managed, SS typically resolves within 24 hours once all serotoninergic medications are discontinued. If inappropriately prescribed, serotoninergic drugs such as antibiotics, analgesics, supplements, or antidepressants may all contribute toward inducing this preventable syndrome, if given in excess. This comprehensive review of SS provides the clinician with a detailed understanding of the pathogenesis, diagnosis, and treatment of this complex disease state. This review contains 5 tables and 26 references Keywords: Serotonin syndrome, altered mental status, hyperactivity, hyperthermia, neuromucular disorder, antidepressants