Possible development of the serotonin syndrome in man

Insel, Thomas R.; Roy, Benjamin F.; Cohen, Robert M.; Murphy, Dennis L.

doi:10.1176/ajp.139.7.954

Cited by 118 publications

(4 citation statements)

References 8 publications

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“…Two main limitations of the multimodal drug approach are (1) potential danger of unwanted side-effects caused by increased action of a particular drug, e.g., hallucinogenic effects of 5-HT 2A receptor activation, emesis and vomiting produced by activation of 5-HT 3 receptors; (2) the danger of the Serotonin Syndrome (SS) development—toxic symptoms produced from too much 5-HT in the central and peripheral nervous system [ 261 , 262 ].…”

Section: Discussionmentioning

confidence: 99%

The Implication of 5-HT Receptor Family Members in Aggression, Depression and Suicide: Similarity and Difference

Попова

Цыбко

Науменко

2022

IJMS

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Being different multifactorial forms of psychopathology, aggression, depression and suicidal behavior, which is considered to be violent aggression directed against the self, have principal neurobiological links: preclinical and clinical evidence associates depression, aggression and suicidal behavior with dysregulation in central serotonergic (5-HT) neurotransmission. The implication of different types of 5-HT receptors in the genetic and epigenetic mechanisms of aggression, depression and suicidality has been well recognized. In this review, we consider and compare the orchestra of 5-HT receptors involved in these severe psychopathologies. Specifically, it concentrates on the role of 5-HT1A, 5-HT1B, 5-HT2A, 5-HT2B, 5-HT2C, 5-HT3 and 5-HT7 receptors in the mechanisms underlying the predisposition to aggression, depression and suicidal behavior. The review provides converging lines of evidence that: (1) depression-related 5-HT receptors include those receptors with pro-depressive properties (5-HT2A, 5-HT3 and 5-HT7) as well as those providing an antidepressant effect (5-HT1A, 5-HT1B, 5-HT2C subtypes). (2) Aggression-related 5-HT receptors are identical to depression-related 5-HT receptors with the exception of 5-HT7 receptors. Activation of 5-HT1A, 5-HT1B, 5-HT2A, 5-HT2C receptors attenuate aggressiveness, whereas agonists of 5-HT3 intensify aggressive behavior.

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Section: Discussionmentioning

confidence: 99%

The Implication of 5-HT Receptor Family Members in Aggression, Depression and Suicide: Similarity and Difference

Попова

Цыбко

Науменко

2022

IJMS

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“…In 1960, Oates and Sjostrand[ 2 ] were the first to report neurological symptoms caused by excessive tryptophan (serotonin)[ 2 ]. Insel et al [ 3 ] coined the term "serotonin syndrome" in 1982[ 3 ]. Although almost six decades have passed since the first description of SS, it remains an enigma in terms of terminology, prevalence, clinical symptoms, diagnostic criteria, and treatment measures.…”

Section: Introductionmentioning

confidence: 99%

Serotonin syndrome controversies: A need for consensus

Prakash,

Shah,

Prakash

2024

World J Crit Care Med

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Serotonin syndrome (SS) is a drug-induced clinical syndrome resulting from increased serotonergic activity in the central nervous system. Although more than seven decades have passed since the first description of SS, it is still an enigma in terms of terminology, clinical features, etiology, pathophysiology, diagnostic criteria, and therapeutic measures. The majority of SS cases have previously been reported by toxicology or psychiatry centers, particularly in people with mental illness. However, serotonergic medications are used for a variety of conditions other than mental illness. Serotonergic properties have been discovered in several new drugs, including over-the-counter medications. These days, cases are reported in non-toxicology centers, such as perioperative settings, neurology clinics, cardiology settings, gynecology settings, and pediatric clinics. Overdoses or poisonings of serotonergic agents constituted the majority of the cases observed in toxicology or psychiatry centers. Overdose or poisoning of serotonergic drugs is uncommon in other clinical settings. Patients may develop SS at therapeutic dosages. Moreover, these patients may continue to use serotonergic medications even if they develop mild to moderate SS due to several reasons. Thus, the clinical presentation (onset, severity, and clinical features) in such instances may not exactly match what toxicologists or psychiatrists observe in their respective settings. They produce considerable diversity in many aspects of SS. However, other experts discount these new developments in SS. Since SS is a potentially lethal illness, consensus is required on several concerns related to SS.

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“…The serotonin syndrome was first described in 1959 in a patient with tuberculosis who received meperidine and died [1]. The syndrome received its current name in 1982 [2]. The significance of serotonin syndrome was brought to attention in 1984 when Libby Zion, an 18-year-old college student, presented to a New York hospital with fever, agitation and confusion.…”

Section: Introductionmentioning

confidence: 99%

The serotonin syndrome—the need for physician’s awareness

Arora

Kannikeswaran

2010

Int J Emerg Med

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BackgroundSerotonin syndrome is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, usually of selective serotonin reuptake inhibitors (SSRIs), intentional excessive use or interactions between various drugs.Case presentationA 16-year-old Caucasian boy presented to our emergency department (ED) with alteration in his mental status for 6 h prior to arrival. On physical examination in our ED, he was combative and disoriented to time, place and person. He was febrile, hypertensive and tachycardic as well. He had intermittent rigid extremities with myoclonus of both lower extremities. A diagnosis of serotonin syndrome (SS) was made based on history of intake of fluoxetine and clinical signs, which included presence of inducible clonus and agitation. The child received supportive care involving intravenous fluids and intravenous lorazepam. The child was back to his baseline mental status and had a normal neurological exam by 24 h and was discharged home later for follow-up with a psychiatrist.ConclusionsSS occurs with increasing frequency, and most cases resolve with prompt recognition and supportive care. Failure to make an early diagnosis and to comprehend adverse pharmacological effects of therapy can lead to adverse outcomes.

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Possible development of the serotonin syndrome in man

Cited by 118 publications

References 8 publications

The Implication of 5-HT Receptor Family Members in Aggression, Depression and Suicide: Similarity and Difference

The Implication of 5-HT Receptor Family Members in Aggression, Depression and Suicide: Similarity and Difference

Serotonin syndrome controversies: A need for consensus

The serotonin syndrome—the need for physician’s awareness

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