Serotonin Syndrome: What is it and why does it happen?

Confusion, palpitations, shivers and tremors are just someone of the symptoms associated with a phenomenon called Serotonin Syndrome. This is a condition where there is an excess of serotonin in your brain. Serotonin, often referred to as the “feel-good” neurotransmitter, plays a crucial role in regulating mood, appetite, and sleep. However, when serotonin levels become excessively elevated, it can lead to a cascade of symptoms that affect various organ systems.

Health Shots got in touch with Dr Balaji B S, Consultant – Neurology & Epileptology, who tells us all that there is to know about Serotonin Syndrome, why does it happen, the symptoms and how to prevent it.

What is serotonin syndrome?

Serotonin syndrome is a condition that occurs when there is extra serotonin, a neurotransmitter, in the brain. This can result in a range of symptoms, some of which can be severe. “The condition is commonly associated with the use of certain medications, particularly those that enhance serotonin activity, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs),” says Dr Balaji. Additionally, the recreational use of substances like ecstasy and other illicit drugs can also contribute to serotonin syndrome.

What are the symptoms of serotonin syndrome?

The symptoms may include mental status changes, autonomic dysfunction, and neuromuscular abnormalities. Here are some symptoms of serotonin syndrome:

• High blood pressure
• Confusion
• Palpitations: Rapid heart rate
• Dilated pupils
• Muscle rigidity
• Diarrhea
• Excessive sweating
• Shivering or tremors

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What are the causes of Serotonin Syndrome?

Here are some causes of serotonin syndrome:

1. Medication Interactions

Combining certain medications, especially those that increase serotonin levels, can trigger serotonin syndrome.

2. Overdose

Taking too much of a single medication that affects serotonin, or a combination of such medications, can lead to the syndrome.

3. Illegal Drugs

Certain recreational drugs like ecstasy can cause a surge in serotonin levels and lead to serotonin syndrome.

How to diagnose serotonin syndrome?

The diagnosis of serotonin is based on symptoms and a review of the individual’s medical history. “There is no test as such that can confirm serotonin syndrome, but tests may be done to rule out other conditions. It’s crucial to inform the doctor about all medications and supplements being taken,” explains Dr Balaji.

How to treat serotonin syndrome?

You need to ideally reverse what caused it. “Treatment typically involves discontinuing medications that contribute to serotonin excess, supportive care, and, in severe cases, the administration of specific medications to counteract the effects of elevated serotonin levels,” says Dr Balaji. Close monitoring in a hospital setting may be necessary to ensure the individual’s safety and well-being. In some instances, severe syndrome can be fatal if not recognised and treated quickly.

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How can you prevent serotonin syndrome?

For preventing serotonin syndrome you need to be honest with your doctors about the medications that you take, including over-the-counter and herbal supplements, to avoid potential interactions. It is essential to adhere to prescribed dosages and report any unusual symptoms promptly.

Are there long-term side effects of serotonin syndrome?

There are typically no long-term effects once serotonin levels are normalised. “However, it is crucial to follow medical advice, attend follow-up appointments, and avoid the substances that initially caused the syndrome. In most cases, with prompt and appropriate treatment, individuals fully recover without lasting complications,” says Dr Balaji.