Serotonin Syndrome [Poisoning]: Criteria for a Timely Diagnosis and Treatment

Course overview

Serotonin syndrome, also termed serotonin poisoning, is a diagnosis of exclusion, and it can be mistaken for an infectious or a metabolic disorder, substance withdrawal, or, more likely, other drug-induced syndromes. The treatment of serotonin poisoning is symptomatic and supportive. Serotonergic drugs are widely used, and intentional overdoses with serotonergic drugs are not uncommon. Serotonin poisoning is a condition caused by an abnormal increase in central nervous system serotonin concentration and/or excessive serotonergic activity. Serotonin poisoning can be an adverse drug effect, a drug-drug reaction, a drug-food reaction, or it can be caused by an overdose of serotonergic drugs. The clinical presentation can be mild and self-limiting, but can develop to a potentially lethal condition. Determining which drugs may be causing serotonin poisoning can be difficult and depend on clinician knowledge and practice, including analytical, objective methods to confirm the diagnosis. Many clinicians are unaware of the criteria for diagnosing serotonin poisoning, and need to be educated on the use of a reliable drug database to check for drug-drug interactions when they are prescribing drugs that can affect serotonin activity and blood levels.