Abstract
Background: Serotonin syndrome is a potentially life-threatening
syndrome with manifestations spanning from mild adverse effects to
life-threatening toxicity. The syndrome is caused by overstimulation of
serotonin receptors by serotonergic drugs. Since the use of serotonergic
drugs is increasing, primarily due to the widespread use of selective
serotonin reuptake inhibitors, cases of serotonin syndrome have likely
seen a parallel increase. The true incidence of serotonin syndrome
remains unknown due to its diffuse clinical presentation.
Objectives: This review aims to provide a clinically focused
overview of serotonin syndrome, covering its pathophysiology,
epidemiology, clinical manifestations, diagnostic criteria, differential
diagnosis, and treatment as well as classifying serotonergic drugs and
their mechanism of action. The pharmacological context is emphasized, as
it is crucial for detection and management of serotonin syndrome.
Methods: Focused review based on a literature search using the
PubMed database.
Findings and conclusion: Serotonin syndrome can occur through
therapeutic use or overdose of a single serotonergic drug, or as a drug
interaction between two or more serotonergic drugs. Central clinical
features consist of neuromuscular excitation, autonomic dysfunction and
altered mental status, occurring in a patient undergoing new or altered
serotonergic therapy. Early clinically recognition and treatment are
crucial to prevent significant morbidity.