Serotonin Syndrome


  • 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


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


  • 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.