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Libby Zion (November 1965 – March 5, 1984) [6] [7] was a freshman at Bennington College in Bennington, Vermont.She took a prescribed MAOI antidepressant, phenelzine, daily. [8] [9] A hospital autopsy revealed traces of cocaine, but other later tests showed no traces.
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 ]
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.
They act by antagonizing the α 2-adrenergic receptor and certain serotonin receptors such as 5-HT 2A and 5-HT 2C, [1] but also 5-HT 3, [1] 5-HT 6, and/or 5-HT 7 in some cases. By blocking α 2 -adrenergic autoreceptors and heteroreceptors , NaSSAs enhance adrenergic and serotonergic neurotransmission in the brain involved in mood regulation ...
Antidepressant discontinuation syndrome, also called antidepressant withdrawal syndrome, is a condition that can occur following the interruption, reduction, or discontinuation of antidepressant medication. [187] The symptoms may include flu-like symptoms, trouble sleeping, nausea, poor balance, sensory changes, and anxiety.
Serotonin syndrome, in which an excess of serotonin in the synapses causes a similar crisis of hypertension and mental confusion, could be confused with an adrenergic storm. Serotonin, being a tryptamine (non-catecholamine) involved in higher brain functions, can cause dangerous hypertension and tachycardia from its effects on the sympathetic ...
There are also reports of patients taking multiple SSRIs with trazodone and precipitating serotonin syndrome. [ 73 ] Trazodone appears to be relatively safer than TCAs , MAOIs , and a few of the other second-generation antidepressants in overdose situations, especially when it is the only agent taken.
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.