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Serotonin syndrome (SS) is a group of symptoms that may occur with the use of certain serotonergic medications or drugs. [1] The symptoms can range from mild to severe, and are potentially fatal. [ 4 ] [ 5 ] [ 2 ] Symptoms in mild cases include high blood pressure and a fast heart rate ; usually without a fever . [ 2 ]
Serotonin syndrome is typically caused by the use of two or more serotonergic drugs, including SSRIs. [118] Serotonin syndrome is a condition that can range from mild (most common) to deadly. Mild symptoms may consist of increased heart rate , fever , shivering, sweating , dilated pupils , myoclonus (intermittent jerking or twitching), as well ...
The diagnosis is suggested on patients with a history of drug exposure to the most common inducing agents such as strong antidopaminergic medications. [6] [40] The differential diagnosis includes serotonin syndrome, [41] encephalitis, toxic encephalopathy, status epilepticus, heat stroke, catatonia and malignant hyperthermia.
Vortioxetine, sold under the brand name Trintellix (in the US) and Brintellix (in the EU) among others, is an antidepressant medication of the serotonin modulator and stimulator (SMS) class used in the treatment of major depressive disorder.
The intensity of the symptoms of serotonin syndrome vary over a wide spectrum, and the milder forms are seen even at nontoxic levels. [157] It is estimated that 14% of patients experiencing serotonin syndrome overdose on SSRIs; meanwhile the fatality rate is between 2% and 12%. [152] [158] [159]
[17] [73] [111] However, there are a handful of case reports of serotonin syndrome occurring with mirtazapine in combination with serotonergic drugs like selective serotonin reuptake inhibitors, although such reports are very rare, and do not necessarily implicate mirtazapine as causative. [17] [112] [113] [114]
Fluoxetine, sold under the brand name Prozac, among others, is an antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class [2] used for the treatment of major depressive disorder, anxiety, obsessive–compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder, and bulimia nervosa. [2]
Overdose is usually treated symptomatically, especially in the case of serotonin syndrome, which requires treatment with cyproheptadine and temperature control based on the progression of the serotonin toxicity. [87] Patients are often monitored for vitals and airways cleared to ensure that they are receiving adequate levels of oxygen.