Serotonin Syndrome

FACTS

• The syndrome may occur within hours of starting a selected medication or when the dosage is increased.
• It can occur regardless of how long a person has been taking the medication.
• Serotonin syndrome is rare however the risk increases if a combination of identified drugs are taken.
• Medications associated with serotonin syndrome
  • SSRI (Selective Serotonin Reuptake Inhibitor)
    • Citalopram (Celexa)
    • Escitalopram (Lexapro)
    • Sertraline (Zoloft)
    • Fluoxetine (Prozac)
    • Paroxetine (Paxil)

• • SNRI (Serotonin-Norepinephrine Reuptake Inhibitor)
    • Duloxetine (Cymbalta)
    • Venlafaxine (Effexor)
    • Desvenlafaxine (Pristiq)
  • Other drugs in combination with SSRI or SNRI
    • Tramadol
    • Triptans for migraines
    • Tri-cyclic antidepressants
    • Trazodone
    • Mirtazapine
    • St John’s Wort
    • Ginseng

SIGNS AND SYMPTOMS

• Diarrhea
• Rapid heartrate
• Muscle spasms and rigidity
• High fever
• Excessive sweating
• Shivering
• Tremors
• Confusion

TREATMENT

• If symptoms are mild, call the provider for guidance.
• If symptoms are moderate to severe, go to the emergency room for care.
• Treatment in intensive care may be needed to support blood pressure, heartrate and breathing.