Serotonin syndrome

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Hyperserotonemia; Serotonergic syndrome

• Restlessness
• Hallucinations
• Loss of coordination
• Fast heart beat
• Rapid changes in blood pressure
• Increased body temperature
• Overactive reflexes
• Nausea
• Vomiting
• Diarrhea

The diagnosis is usually made by asking questions about your medical history, including the types of drugs you take.

To be diagnosed with serotonin syndrome, you must have been taking a drug that changes the body's serotonin levels (serotonergic drug) and have at least three of the following signs or symptoms:

• Agitation
• Uncoordinated movements (ataxia)
• Heavy sweating not due to activity (diaphoresis)
• Diarrhea
• Overactive reflexes (hyperreflexia)
• Fever
• Mental status changes such as confusion or hypomania
• Muscle spasms (myoclonus)
• Shivering
• Tremor

If you have just start taking or increased the dosage of a tranquilizer (neuroleptic drug), other conditions (such as neuroleptic malignant syndrome) will be considered. Serotonin syndrome is not diagnosed until all other possible causes have been ruled out, including infections, intoxications, metabolism problems, and drug withdrawal. Some symptoms of serotonin syndrome can mimic those due to an overdose of cocaine, lithium, or an MAOI.

Tests may include:

• CBC
• Thyroid function tests
• Drug screen
• Electrocardiogram (ECG)

Review Date: 08/01/2006
Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network.