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Several years later, physicians concluded the combination of phenelzine and the pethidine given to her by Stone and Weinstein contributed to the development of serotonin syndrome, which led to increased agitation. This led Zion to pull on her intravenous catheter, causing Weinstein to order physical restraints, which Zion also fought against ...
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 ...
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.
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.
Almost any medication involved with serotonin regulation has the potential to cause serotonin toxicity (also known as serotonin syndrome) – an excess of serotonin that can induce mania, restlessness, agitation, emotional lability, insomnia, and confusion as its primary symptoms.
Niaprazine (Nopron) – a drug related to this group but does not inhibit the reuptake of serotonin or the other monoamines. Medifoxamine (Clédial, Gerdaxyl) – could perhaps technically be said to belong to this group, as it is a serotonin–dopamine reuptake inhibitor and 5-HT 2A and 5-HT 2C receptor antagonist, but not grouped as such. [1]
Physicians often add a medication with a different mode of action to bolster the effect of an antidepressant in cases of treatment resistance; a 2002 large community study of 244,859 depressed Veterans Administration patients found that 22% had received a second agent, most commonly a second antidepressant. [83]