Serotonin is a natural chemical produced by the body and acts as a neurotransmitter, meaning that it sends messages between the nerve cells of the brain (neurons) and the body. It is mainly present in the digestive system, brain and platelets. When you suffer from serotonin syndrome (also called serotoninergic), it means that this element has reached dangerously high levels, especially due to drugs, drug interactions or, albeit rarely, some supplements. The most common symptoms are agitation, confusion, disorientation, rapid heartbeat, chills, excessive sweating, and more. If you are concerned that you have this condition, learn how to treat it so that you stay safe and healthy.
Steps
Method 1 of 3: Treating Serotonin Syndrome
Step 1. Stop taking medications
If you have started a new drug therapy or a new combination of drugs and have some of the moderate symptoms described above, talk to your doctor to consider stopping the treatment. If you can't contact him, stop taking your medications anyway until you can talk to him. If the syndrome is mild, the effects usually subside within one to three days.
- You should call your doctor to let him know that you have stopped taking your medications so that he can find others that are more suitable for your situation.
- You should only abruptly stop therapy if you have been on medication for a few weeks.
Step 2. See your doctor if you have been taking your medications for some time
If the therapy has been going on for a few weeks, it is important to contact him before stopping it; many antidepressants and other types of medicines that are responsible for the syndrome can trigger serious side effects when stopped abruptly.
The doctor evaluates alternative treatments with you to find the best solution and make you take all the active ingredients you need
Step 3. Take antiserotonergics
If your symptoms do not subside within a few days, if you have been taking medications that cause the syndrome for a long time, or if you are experiencing troubling conditions that indicate a serious reaction (very high blood pressure, altered mental status, etc.), you should look for immediate medical attention. In this case, prescription antiserotonergic drugs are needed to help reduce discomfort.
- If treated promptly and appropriately, symptoms usually resolve within 24 hours.
- Your doctor can monitor your health condition to make sure you are starting to get better.
- A drug that inhibits the effects of serotonin is cyproheptadine.
Step 4. Go to the emergency room if you have severe symptoms
If you have started a new drug treatment or a combination of various active ingredients and develop some of the more serious reactions described above, stop it immediately and call the emergency services. If you experience severe symptoms, it means that you are facing a life-threatening situation, especially as the ailments progress rapidly.
- Among the most dangerous are fever, chills, arrhythmia and loss of consciousness.
- In this case, hospitalization may be required; you may be given drugs to block the action of serotonin, relax your muscles, control your blood pressure and heart rate. Sometimes, oxygen therapy and intravenous fluid intake is required, as well as a series of breathing support procedures.
Step 5. Undergo other tests
There is no single laboratory test that can uniquely detect serotonin syndrome; diagnosis is mainly based on evaluating the symptoms and medications you are taking; however, it is important to rule out other disorders, such as drug withdrawal, malignant hyperthermia, overdose, and others.
To rule out other aetiologies, the doctor or hospital staff may request further investigation
Method 2 of 3: Recognize the Symptoms
Step 1. Pay attention to the state of agitation
Serotonin syndrome basically consists of an overexcitation of the nervous system and the symptoms reflect this pathological condition. You may feel nervous, restless or irritable and as a result suffer from rapid heartbeat and palpitations; the pupils may be dilated and blood pressure may be elevated.
Step 2. Monitor for confusion or loss of coordination
They represent other typical symptoms of the syndrome; you may appear very clumsy in your movements, your muscles may be uncoordinated, you may have difficulty walking, driving or carrying out normal daily activities.
You may complain of excessive muscle stiffness, as well as fasciculations or tics
Step 3. Check for other body changes
In the presence of this syndrome, you may also sweat a lot or, conversely, have chills or goosebumps all over your body.
Other ailments are diarrhea or headache
Step 4. Pay attention to severe symptoms
There are some troubling signs associated with the disease that indicate a significant reaction; these symptoms can lead to death and in their presence you must call 911 immediately. Here are the main ones:
- High fever;
- Convulsions;
- Arrhythmia;
- Loss of consciousness;
- Hypertension;
- Altered mental state.
Step 5. Know that symptoms can begin within a short time
They usually go wild within a few hours of taking the prescription, over-the-counter, or even herbal supplement. the syndrome develops more easily when you combine one or more substances.
- In most cases, it occurs within 6 to 24 hours of changing the dosage or starting a new therapy.
- This disease can be serious and even fatal; therefore, if you are taking medication or have started a new treatment and have such symptoms, you should call your doctor, ambulance or go to the emergency room immediately.
Method 3 of 3: Understanding the Syndrome
Step 1. Know the causes of the disease
Any drug or substance that increases the amount of serotonin in the body (or reduces its breakdown in the body) can trigger it to build up to dangerously high levels and potentially give rise to the syndrome. There are several medicines - especially antidepressants - that cause this disorder, which develops especially when it is abused consciously or not. In most cases, the syndrome is triggered when drugs of different classes are combined, including:
- Selective serotonin reuptake inhibitors (SSRIs): these are antidepressants and this category includes citalopram, fluoxetine (Prozac), fluvoxamine, paroxetine and sertraline (Zoloft);
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): it is a class of antidepressants similar to SSRIs to which trazodone, duloxetine (Cymbalta) and venlafaxine (Efexor) belong;
- Monoamine oxidase (MAO) inhibitors: this group includes antidepressants such as isocarboxazid and phenelzine (Margyl);
- Other antidepressants: among these you find bupropion (Zyban) and tricyclic ones, such as amitriptyline and nortriptyline (Noritren);
- Medicines for migraine: this category includes triptans (Imigran, Maxalt, Almogran), carbamazepine (Tegretol) and valproic acid (Depakin);
- Pain relievers: These include cyclobenzaprine (Flexiban), fentanyl (Duragesic), meperidine (Demerol) and tramadol (Contramal);
- Mood stabilizers: the main active ingredient in this category is lithium;
- Antiemetic drugs: among these are granisetron (Kytril), metoclopramide (Plasil), droperidol (Inapsine) and ondansetron (Zofran);
- Antibiotics and antivirals: this category includes linezolid, which is an antibiotic, and ritonavir (Norvir), which is an antiretroviral used for the treatment of HIV / AIDS;
- Over-the-counter antitussives and cold medicines that contain dextromethorphan: among these there are Bronchenolo Tosse, Actigrip Tosse and other drugs on sale;
- Illegal drugs: in particular LSD, ecstasy, cocaine and amphetamines;
- Herbal supplements: St. John's wort, ginseng and nutmeg fall into this group.
Step 2. Prevent the syndrome
If you want to prevent it from developing, you should always tell your treating doctor about all medications and supplements you are taking. Herbal remedies such as St. John's wort can interact with prescription medicines, just as the latter can interfere with other active ingredients. Taking prescribed medications without first giving the doctor a full picture of the situation can actually lead to problems.
- For example, if your doctor does not know that you are taking the lithium that another specialist has prescribed for you and recommends an SSRI, the interaction between the two substances can increase the risk of generating serotonin syndrome.
- Take only the prescribed dosage; do not try to change the dosage on your own by taking larger quantities than indicated by your doctor.
Step 3. Know the categories that run the highest risk
People who take different types of medicines of different classes potentially responsible for the syndrome are more exposed to the disorder; symptoms usually occur when the dosage is increased or a new therapy is started. If you take several active ingredients from different classes, you need to carefully monitor your symptoms, especially if you have recently started a new treatment.
