Seratonin Syndrome is a condition where we have far too much serotonin, such as for instance if you take MAOIs and SSRIs at the same time.
Heres a few articles about it on the web. Please be aware that this post was first put in this thread March 2002 and as the internet is not guaranteed to stay the same, any links may no longer work after a time. You may have to search hard to find the same doc.
Medical Emergencies in Psychiatry
Gerard Clancy, M.D.
Peer Review Status: Internally Peer Reviewed
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4. Serotonin Syndrome
Monoamine oxidase inhibitors (MAOls) in combination with other antidepressants such as selective serotonin inhibitors (SSRls - Prozac, Zoloft, Paxil or Luvox), Wellbutrin (Bupropion), Tryptophan or tricyclic antidepressants can lead to a sudden build up of serotonin systemically. This condition can be life threatening.
Signs and symptoms of Serotonin Syndrome
Hyperthermia, diaphoresis, excitement or confusion, hyper-reflexic, hypotension, tremor. Complications include Disseminated Intravascular Coagulation (D.I.C.), Rhabdomyolisis and cardiovascular comprimise.
Treatment ot Serotonin Syndrome
This condition warrants medical consultation. Initial steps include discontinuing the offending agents and supporting the patients vitals. Dantrolene (a potent muscle relaxant) and Periactin (Cyproheptadine - a potent antihistamine and serotonin antagonist).
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http://www.findarticles.com/cf_dls....effectsSerotonin syndrome alert.
Author/s: Joel Shuster
Issue: July, 1999
Serotonin syndrome alert
THIS RARE ADVERSE REACTION TO CERTAIN ANTIDEPRESSANTS CAN BE FATAL.
A 45-YEAR-OLD MAN WAS BROUGHT INTO THE ED BY HIS coworkers, who reported that he'd returned from his lunch break acting "drunk" and later admitted he'd done a few lines of cocaine. The patient's symptoms were similar to those of neuroleptic malignant syndrome, including elevated temperature, confusion, and muscle rigidity. But he was taking fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI), not a neuroleptic drag. The nurse suspected serotonin syndrome, a rare but potentially fatal adverse reaction to serotoninergic drags.
What went wrong?
First described in the 1950s, serotonin syndrome--an excess of serotonin in the bloodstream is a rare condition that has become more prevalent with the widespread use of SSRI antidepressants. Serotoninergic drags--including fluoxetine, sertraline, and paroxetine--are used to treat depression, migraine, and anxiety disorders. Serotomimetic drags include dextromethorphan, meperidine, and street drags such as cocaine and LSD. The combination most frequently leading to serotonin syndrome is a monoamine oxidase (MAO) inhibitor given with an SSRI.
Signs and symptoms fall into three categories:
* mental status and behavioral changes, such as disorientation, confusion, and agitation
* motor system changes, such as myoclonus, rigidity, hyperreflexia, and tremor
* autonomic nervous system instability, such as shivering, diaphoresis, fever, diarrhea, dyspnea, and tachycardia.
In severe cases, serotonin syndrome can progress to seizures, disseminated intravascular coagulation, renal failure, coma, and death.
What precautions can you take?
Warn patients and their families about the possibility of serotonin syndrome. Encourage them to tell their health care providers about all the medications they're taking, including over-the-counter and street drugs, and to report any subtle changes such as increasing confusion, unusual behavior, or agitation, which may be early signs of serotonin syndrome. Tell patients to stop using an MAO inhibitor 14 days before starting SSRI therapy.