The serotonin syndrome and its treatment
by
Gillman PK
Consultant Psychiatrist,
Mount Pleasant,
Queensland, Australia.
gillman.k.i@m130.aone.net.au
J Psychopharmacol 1999; 13(1):100-9

ABSTRACT

Serotonin syndrome is caused by drug induced excess of intrasynaptic 5-hydroxytryptamine. The clinical manifestations are mediated by the action of 5-hydroxytryptamine on various subtypes of serotonin receptors. There is no effective drug treatment established. The history of the treatment of serotonin syndrome with 5-hydroxytryptamine blocking drugs is reviewed. A literature search was undertaken using both Medline and a manual search of the older literature. Reports of cases treated with the 5-HT2 blockers cyproheptadine and chlorpromazine were identified and analysed. There is some evidence suggesting the efficacy of chlorpromazine and cyproheptadine in the treatment of serotonin syndrome. The evidence for cyproheptadine is less substantial, perhaps because the dose of cyproheptadine necessary to ensure blockade of brain 5-HT2 receptors is 20-30 mg, which is higher than that used in the cases reported to date (4-16 mg).

See also: Psychotropical.com (Dr Ken Gillman), especially SS/ST info

TCAs
SSRIs
5-HT2a
Serotonin
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Methylphenidate
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The serotonin syndrome and antidepressants

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