Clinical Pediatric Emergency Medicine
Volume 6, Issue 2 , Pages 103-108 , June 2005

Serotonin Syndrome—What Have We Learned?

  • Michael Ganetsky, MD

      Affiliations

    • Corresponding Author InformationReprint requests and correspondence: Michael Ganetsky, MD, Department of Emergency Medicine University Campus, 55 Lake Avenue, North Worcester, MA 01655, USA.
    • ,
  • D. Eric Brush, MD

References 

  1. Eadie MJ. Convulsive ergotism: epidemics of the serotonin syndrome?. Lancet Neurol. 2003;2:429–434
  2. Baloh RW, Dietz J, Spooner JW. Myoclonus and ocular oscillations induced by l-tryptophan. Ann Neurol. 1982;11:95–97
  3. Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991;148:705–713
  4. Curry SC, Mills KC, Graeme KA. Neurotransmitters. In:  Goldfrank LR,  Flomenbaum NE,  Lewin NA, et al. editor. Goldfrank's toxicologic emergencies. 7th ed.. New York (NY): McGraw-Hill; 2002;p. 147–150
  5. Sporer KA. The serotonin syndrome, implicated drugs, pathophysiology and management. Drug Saf. 1995;13:94–104
  6. Van OD, Megens A, Meert T, et al. Functional study of rat 5-HT2A receptors using antisense oligonucleotides. J Neurochem. 2003;85:1087–1100
  7. Nisijima K, Shioda K, Yoshino T, et al. Diazepam and chlormethiazole attenuate the development of hyperthermia in an animal model of the serotonin syndrome. Neurochem Int. 2003;43:155–164
  8. Nisijima K, Yoshino T, Yui K, et al. Potent serotonin (5-HT)(2A) receptor antagonists completely prevent the development of hyperthermia in an animal model of the 5-HT syndrome. Brain Res. 2001;890:23–31
  9. McDaniel WW. Serotonin syndrome: early management with cyproheptadine. Ann Pharmacother. 2001;35:870–873
  10. Mason PJ, Morris VA, Balcezak TJ. Serotonin syndrome: presentation of 2 cases and review of the literature. Medicine. 2000;79:201–209
  11. Baigel GD. Cyproheptadine and the treatment of an unconscious patient with the serotonin syndrome. Eur J Anaesthesiol. 2003;20:586–588
  12. Turkel SB, Nadala JG, Wincor MZ. Possible serotonin syndrome in association with 5-HT3 antagonist agents. Psychosomatics. 2001;42:258–260
  13. Duggal HS, Fetchko J. Serotonin syndrome and atypical antipsychotics. Am J Psychiatry. 2002;159:672–673
  14. Nisijima K, Nibuya M, Sugiyama H. Abnormal CSF monoamine metabolism in serotonin syndrome. J Clin Psychopharmacol. 2003;23:528–531
  15. Whyte IM, Dawson AH. Redefining the serotonin syndrome. J Toxicol Clin Toxicol. 2002;40:668–669
  16. Isbister GK, Bowe SJ, Dawson A, et al. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol. 2004;42:277–285
  17. Arnold DH. Consultation with the specialist: the central serotonin syndrome: paradigm for psychotherapeutic misadventure. Pediatr Rev. 2002;23:427–432
  18. Godinho EM, Thompson AE, Bramble DJ. Neuroleptic withdrawal versus serotonergic syndrome in an 8-year-old child. J Child Adolesc Psychopharmacol. 2002;12:265–270
  19. Gill M, LoVecchio F, Selden B. Serotonin syndrome in a child after a single dose of fluvoxamine. Ann Emerg Med. 1999;33:457–459
  20. Spirko BA, Wiley JF. Serotonin syndrome: a new pediatric intoxication. Pediatr Emerg Care. 1999;15:440–443
  21. Pao M, Tipnis T. Serotonin syndrome after sertraline overdose in a 5-year-old girl. Arch Pediatr Adolesc Med. 1997;151:1064–1067
  22. Kaminski CA, Robbins MS, Weibley RE. Sertraline intoxication in a child. Ann Emerg Med. 1994;23:1371–1374
  23. Hegerl U, Bottlender R, Gallinat J, et al. The serotonin syndrome scale: first results on validity. Eur Arch Psychiatry Clin Neurosci. 1998;248:96–103
  24. Kaneda Y, Ishimoto Y, Ohmori T. Mild serotonin syndrome on fluvoxamine. Int J Neurosci. 2001;109:165–172
  25. Dunkley EJ, Isbister GK, Sibbritt D, et al. The hunter serotonin toxicity criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96:635–642
  26. Ziervogel CF. Selective serotonin re-uptake inhibitors for children and adolescents. Eur Child Adolesc Psychiatry. 2000;9:I20–I26
  27. Karki SD, Masood GR. Combination risperidone and SSRI-induced serotonin syndrome. Ann Pharmacother. 2003;37:388–391
  28. Haslett CD, Kumar S. Can olanzapine be implicated in causing serotonin syndrome?. Psychiatry Clin Neurosci. 2002;56:533–535
  29. Tissot TA. Probable meperidine-induced serotonin syndrome in a patient with a history of fluoxetine use. Anesthesiology. 2003;98:1511–1512
  30. Lange-Asschenfeldt C, Weigmann H, Hiemke C, et al. Serotonin syndrome as a result of fluoxetine in a patient with tramadol abuse: plasma level–correlated symptomatology. J Clin Psychopharmacol. 2002;22:440–441
  31. Egberts AC, ter Borgh J, Brodie-Meijer CC. Serotonin syndrome attributed to tramadol addition to paroxetine therapy. Int Clin Psychopharmacol. 1997;12:181–182
  32. Mason BJ, Blackburn KH. Possible serotonin syndrome associated with tramadol and sertraline coadministration. Ann Pharmacother. 1997;31:75–77
  33. Bernard L, Stern R, Lew D, et al. Serotonin syndrome after concomitant treatment with linezolid and citalopram. Clin Infect Dis. 2003;36:1197
  34. Mathew NT. Serotonin syndrome complicating migraine pharmacotherapy. Cephalalgia. 1996;16:323–327
  35. Prior FH, Isbister GK, Dawson AH, et al. Serotonin toxicity with therapeutic doses of dexamphetamine and venlafaxine. Med J Aust. 2002;176:240–241
  36. Fisher AA, Davis MW. Serotonin syndrome caused by selective serotonin reuptake-inhibitors–metoclopramide interaction. Ann Pharmacother. 2002;36:67–71
  37. Ubogu EE, Katirji B. Mirtazapine-induced serotonin syndrome. Clin Neuropharmacol. 2003;26:54–57
  38. Hernandez JL, Ramos FJ, Infante J, et al. Severe serotonin syndrome induced by mirtazapine monotherapy. Ann Pharmacother. 2002;36:641–643
  39. Pan JJ, Shen WW. Serotonin syndrome induced by low-dose venlafaxine. Ann Pharmacother. 2003;37:209–211
  40. Lenzi A, Raffaelli S, Marazziti D. Serotonin syndrome–like symptoms in a patient with obsessive-compulsive disorder, following inappropriate increase in fluvoxamine dosage. Pharmacopsychiatry. 1993;26:100–101
  41. Rosebush PI, Margetts P, Mazurek MF. Serotonin syndrome as a result of clomipramine monotherapy. J Clin Psychopharmacol. 1999;19:285–287
  42. DeSilva KE, Le Flore DB, Marston BJ, et al. Serotonin syndrome in HIV-infected individuals receiving antiretroviral therapy and fluoxetine. AIDS. 2001;15:1281–1285
  43. Lee DO, Lee CD. Serotonin syndrome in a child associated with erythromycin and sertraline. Pharmacotherapy. 1999;19:886–894
  44. Lantz MS, Buchalter E, Giambanco V. St John's wort and antidepressant drug interactions in the elderly. J Geriatr Psychiatry Neurol. 1999;12:7–10
  45. Fugh-Berman A. Herb-drug interactions. Lancet. 2000;355:134–138
  46. Dannawi M. Possible serotonin syndrome after combination of buspirone and St John's wort. J Psychopharmacol. 2002;16:401
  47. Parker V, Wong AH, Boon HS, et al. Adverse reactions to St John's wort. Can J Psychiatry. 2001;46:77–79
  48. Brush DE, Bird SB, Boyer EW. Monoamine oxidase inhibitor poisoning resulting from internet misinformation on illicit substances. J Toxicol Clin Toxicol. 2004;32:191–195
  49. Parrott AC. Recreational Ecstasy /MDMA, the serotonin syndrome, and serotonergic neurotoxicity. Pharmacol Biochem Behav. 2002;71:837–844
  50. Oesterheld JR, Armstrong SC, Cozza KL. Ecstasy: pharmacodynamic and pharmacokinetic interactions. Psychosomatics. 2004;45:84–87
  51. Vuori E, Henry JA, Ojanpera I, et al. Death following ingestion of MDMA (Ecstasy) and moclobemide. Addiction. 2003;98:365–368
  52. Bodner RA, Lynch T, Lewis L, et al. Serotonin syndrome: views & reviews. Neurology. 1995;45:219–223
  53. Horowitz Z, Mullins ME. Cyproheptadine for serotonin syndrome in an accidental pediatric sertraline ingestion. Pediatr Emerg Care. 1999;15:325–327
  54. Boddy R, Ali R, Dowsett R. Use of sublingual olanzapine in serotonin syndrome. J Toxicol Clin Toxicol. 2004;42:725;[abstract]
  55. Suchard J, Erickson R. Serotonin syndrome from acute olanzapine overdose. J Toxicol Clin Toxicol. 2004;42:718;[abstract]
  56. Gillman PK. Serotonin syndrome treated with chlorpromazine. J Clin Psychopharmacol. 1997;17:128–129
  57. Guze BH, Baxter L. The serotonin syndrome: case responsive to propranolol. J Clin Psychopharmacol. 1986;6:119–120
  58. Nisijima K, Nibuya M, Kato S. Toxic serotonin syndrome successfully treated with electroconvulsive therapy. J Clin Psychopharmacol. 2002;22:338–339

PII: S1522-8401(05)00057-1

doi: 10.1016/j.cpem.2005.04.009

Clinical Pediatric Emergency Medicine
Volume 6, Issue 2 , Pages 103-108 , June 2005

Article Tools