Serotonin is a chemical produced in your body that enables cells in your body to communicate with one another. Serotonin is commonly referred to as the chemical that helps make you happy and calm. If you have too little serotonin in your body, the result is anxiety and/or depression.
However, if your body has too much serotonin, commonly known as Serotonin Syndrome, it can lead to excessive nerve cell activity that can potentially be deadly.
What are serotonin syndrome symptoms?
Typical symptoms of serotonin syndrome usually occur within several hours of taking a new drug or increasing the dose of a drug you’re already taking.
These symptoms can surface as any of the following:
- Dilated pupils
- Agitation or restlessness
- Heavy sweating
- Changes in blood pressure
- Nausea and/or vomiting
- Loss of muscle coordination (twitching)
- Changes in blood pressure
- Rapid heart rate
- Shivering and goosebumps
In some cases, serotonin syndrome can be deadly. These life-threatening signs and symptoms are:
- High fever
- Irregular heartbeat
What causes serotonin syndrome?
There are over-the-counter and prescription drugs that are associated with serotonin syndrome, especially antidepressants.
Here is a list of drugs that can lead to Serotonin Syndrome:
- Selective serotonin reuptake inhibitors (SSRIs)
- antidepressants such as citalopram (Celexa)
- fluoxetine (Prozac, Sarafem)
- fluvoxamine paroxetine (Paxil) and sertraline (Zoloft)
- paroxetine (Paxil)
- sertraline (Zoloft)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- antidepressants such as trazodone
- duloxetine (Cymbalta)
- venlafaxine (Effexor)
- Bupropion (Wellbutrin, Zyban)
- Tricyclic antidepressants
- nortriptyline (Pamelor)
- Monoamine oxidase inhibitors (MAOIs)
- isocarboxazid (Marplan)
- phenelzine (Nardil)
- Anti-migraine medications
- triptans (Axert, Amerge, Imitrex)
- carbamazepine (Tegretol)
- valproic acid (Depakene)
- Pain medications
- Opioid pain medications including codeine (Tylenol with codeine)
- fentanyl (Duragesic)
- hydrocodone meperidine (Demerol)
- oxycodone (Oxycontin, Percocet, Percodan)
- tramadol (Ultram)
- Illicit drugs
- Herbal supplements
- St. John’s wort
- Over-the-counter cough and cold medications
- Anti-nausea medications
- metoclopramide (Reglan)
- droperidol (Inapsine)
- ondansetron (Zofran)
- Linezolid (Zyvox)
- Ritonavir (Norvir)
Serotonin syndrome treatments
The good news is that milder forms of serotonin syndrome usually go away within 24 to 72 hours. If you have symptoms, you should stop medications that increase serotonin, and take medications to block the effects of serotonin already in your system if they’re needed.
Depending on your symptoms, you may receive the following treatments:
- A breathing tube and medication to paralyze your muscles.
- Muscle relaxants
- Oxygen and intravenous (IV) fluids
- Drugs that control heart rate and blood pressure
- Serotonin-production blocking agents