Related Experiment Video
Updated: Jun 12, 2026

Rapid In Situ Hybridization using Oligonucleotide Probes on Paraformaldehyde-prefixed Brain of Rats with Serotonin Syndrome
Published on: September 23, 2015
The role of methylene blue in serotonin syndrome: a systematic review
Bradley K W Ng1, Andrew J D Cameron
1correspondence and Aged Care Mental Health, Robina Hospital, Gold Coast Health Service District, Locked Bag 15, Robina, QLD 4226, Australia. bkwng@hotmail.com
Background:
A recent series of case reports has demonstrated a significant, previously unrecognized drug interaction between serotonin reuptake inhibitors (SRIs) and methylene blue (MB).
Objective:
The authors review the case reports and clinical audits relevant to this interaction and consider the diagnosis of serotonin syndrome in these cases.
Method:
Articles were obtained from a systematic search of MEDLINE and PsychInfo databases, and from the bibliographies of relevant articles. Studies were considered relevant if the patient received MB and developed an acute confusional state, neuropsychiatric complications, or autonomic instability.
Results:
The review identified nine case reports and two retrospective reviews; 26 patients developed an acute confusional state after MB infusion; 24 of these patients were taking an SRI, and 1 was taking clomipramine. Serotonin syndrome was a possible diagnosis in all 25 of these patients.
Conclusion:
SRIs can interact with MB, causing a serious adverse reaction consistent with serotonin syndrome.
Related Concept Videos
Antidepressant Drugs: MAOIs and Other Agents
Phase II Reactions: Methylation Reactions
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Drugs Affecting Neurotransmitter Synthesis
