Serotonin Syndrome/Serotonin Toxicity

Talton, Cynthia Wright

doi:10.12788/fp.0042

Cited by 10 publications

(8 citation statements)

References 31 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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“…This is the first report of a mood disorder patient with RTHβ who had severe side effects of antidepressants. The characteristic feature in this case was that the patient repeatedly developed serotonin syndrome‐like symptoms 6 when antidepressants involving serotonin and noradrenaline were administered. On the other hand, the pathogenesis of the clouding of consciousness and clonus is caused by the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine and serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine, but not by the selective serotonin reuptake inhibitor (SSRI) paroxetine during the first admission to our hospital is unknown.…”

Section: Discussionmentioning

confidence: 94%

A case of mood disorder with severe side effects of antidepressants in association with resistance to thyroid hormone beta with a THRB mutation

Komahashi‐Sasaki

Yasuda

Maehara

et al. 2022

Neuropsychopharm Rep

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Psychiatric disorders are highly integrated with thyroid disorders; T3 is closely related to depression and anxiety because of its ability to regulate serotonin and noradrenaline. 1 It is also known that psychiatric symptoms often persist after thyroid function is normalized by treatment. 1 In addition, previous studies have shown that bipolar disorder is closely related to thyroid dysfunction. Psychiatric medications can affect thyroid function to a greater or lesser extent, and thyroid hormone (TH) levels can also affect the effectiveness of medications, 2 while thyroid autoimmunity has been suggested to be an independent risk factor for mood disorders. 3 Thyroid hormone resistance (RTH) is a clinical syndrome defined by decreased sensitivity to TH, commonly caused by mutations in the thyroid hormone receptor beta (RTHβ) gene, and referred to as RTH beta or Refetoff syndrome. 4 The exact incidence of RTHβ is unknown because RTHβ is rarely detected by routine thyroidstimulating hormone (TSH)-based newborn screening programs, but

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“…Serotonin syndrome symptoms normally present within 24 h of initiation or dose change of serotonergic medication. 18 Therefore, if patients did not report an episode of serotonin syndrome post-arthroplasty or there was no correspondence pertaining to a subsequent hospitalization, it is possible that our data did not capture the event.…”

Section: Adverse Effects Associated With Tramadol and Antidepressantsmentioning

confidence: 99%

Tramadol as a patient‐initiated component of multimodal pain management: a pilot study of 364 lower limb arthroplasty cases

Mitchell²

2023

ANZ Journal of Surgery

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BackgroundMultimodal therapy (MMT) for analgesia following joint arthroplasty continues to reduce cost and the requirement of strong opioids post‐operatively. Tramadol immediate release is an important MMT component providing synergistic pain relief via dual μ‐opioid agonism and serotonin and noradrenaline reuptake inhibition. Case reports have shown tramadol when combined with antidepressants cause serotonin syndrome, but this has yet to be demonstrated in larger studies. We undertook a pilot study assessing the functional outcomes and incidence of side effects associated with tramadol in lower limb arthroplasty patients with a focus on those taking concomitant antidepressants.MethodsPrimary and revision hip and knee arthroplasties performed in 2018–2019 by a senior surgeon were included (n = 364). Patient records were assessed to determine pain scores, length of hospitalization, prescription of tramadol and antidepressants, self‐reported side effects and previous adverse reactions associated with tramadol.ResultsNine‐five percentage of patients had been prescribed tramadol, and 16% had concurrent prescription of tramadol and one or more antidepressants. The total rate of adverse effects associated with tramadol before and during the study was 7% (n = 25) including two cases of concomitant tramadol and antidepressant use. For patients on tramadol, median 2‐week post‐operative pain score was 1.5 (IQR 1–2.5) out of 10 and hospitalization length was 1 (IQR 1–2) days.ConclusionTramadol immediate release appears to be well tolerated among our patient population with no significantly increased prevalence of side effects when co‐administered with low and moderate dose antidepressants.

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Serotonin Syndrome/Serotonin Toxicity

Cited by 10 publications

References 31 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

A case of mood disorder with severe side effects of antidepressants in association with resistance to thyroid hormone beta with a THRB mutation

Tramadol as a patient‐initiated component of multimodal pain management: a pilot study of 364 lower limb arthroplasty cases

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