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Published on: September 23, 2015
Recognizing serotonin toxicity in the pediatric emergency department
1Division of Pediatric Emergency Medicine, Birmingham School of Medicine, University of Alabama, Birmingham, AL 35233, USA. skant@peds.uab.edu
Pediatric Emergency Care
|August 7, 2012
Summary
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) use has increased, raising serotonin toxicity risks. This review covers SSRI/SNRI toxicity, proserotonergic agents, and serotonin syndrome criteria.
Area of Science:
- Pharmacology
- Clinical Toxicology
- Psychiatry
Background:
- Widespread use of SSRIs and SNRIs for mood and behavioral disorders has increased over two decades.
- This rise correlates with a greater incidence of serotonin toxicity.
- Healthcare providers need awareness of combined medication risks.
Purpose of the Study:
- Review adverse effects and overdose toxicity of specific serotonergic medications.
- Identify other proserotonergic substances contributing to serotonin excess.
- Define diagnostic criteria and treatment for serotonin syndrome/toxicity.
Main Methods:
- Literature review of selective serotonin reuptuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
- Analysis of proserotonergic drug interactions and toxicity profiles.
- Synthesis of clinical presentation and diagnostic criteria for serotonin syndrome.
Main Results:
- SSRIs and SNRIs, while generally safer than older antidepressants, carry risks of serotonin toxicity.
- Numerous other medications and substances can potentiate serotonergic effects.
- Serotonin syndrome presents as a triad: altered mental status, autonomic hyperactivity, and neuromuscular abnormalities.
Conclusions:
- Increased SSRI/SNRI use necessitates vigilance regarding serotonin toxicity.
- Understanding drug interactions is crucial for preventing serotonin syndrome.
- Accurate diagnosis and prompt treatment are vital for managing serotonin toxicity.
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