The serotonin syndrome; Four case reports and a concise review of the literature

Author(s): Tuinier, S.

Journal/Book: Eur J Psychiat. 1998; 12: PO Box 6029, 50080 Saragoose, Spain. European Journal of Psychiatry. 12-18.

Abstract: The serotonin syndrome, characterized among others by confusion, restlessness, myoclonus, hyperreflexia, tremor, ataxia and hyperthermia, is a rarely described complication of treatment with serotonin enhancing antidepressants. The differential diagnosis comprises delirious states and neuroleptic malignant syndrome. The pathogenesis is thought to be related to activation or changes in the sensitivity of 5-HT1a subreceptor systems in brain stem and spinal cord or an overall enhancement of 5-HT neurotransmission. Symptomatology and etiological factors are described by reporting four patients. It is concluded that this complication may be underreported in view of the increasing use of antidepressants with a more or less specific serotoninergic mode of action.

Note: Article Verhoeven MAW, Vincent Van Gogh Inst Psychiat, Stn Weg 46, NL-5803 AC Venray, NETHERLANDS

Keyword(s): serotonin syndrome; antidepressants; 5-HT1a and 5-HT2 receptor subtypes; pharmacogenetic factors; NEUROLEPTIC MALIGNANT SYNDROME; DELIRIUM; SYSTEM; MDMA

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