Serotonin syndrome: Difference between revisions

[[Serotonin]] is a [[neurotransmitter]] involved in many aspects of the body, including mood regulation (where it is belived to be involved in depression, anxiety, aggression, mania), appetite, digestion, sleeping, memory, libido, pain, and potentially migraines.{{citation needed}} In humans, the effects of excess serotonin were first noted in 1960 in patients receiving a [[MAOI]] and tryptophan in combination.{{citation needed}} The syndrome is caused by an unregulatable excess of serotonin in the central nervous system. Other neurotransmitters may also play a role; NMDA receptor antagonists and [[GABA]] have been suggested as being involved in the development of the syndrome.{{citation needed}}

A large number of medications (either alone in high dose{{notetag|Several reports exist claiming serotonin syndrome to have been triggered by tramadol alone, at therapeutic or moderate doses.<ref name="VizcaychipiWalker2007">{{cite journal|last1=Vizcaychipi|first1=M.P.|last2=Walker|first2=S.|last3=Palazzo|first3=M.|title=Serotonin syndrome triggered by tramadol|journal=British Journal of Anaesthesia|volume=99|issue=6|year=2007|pages=919|issn=00070912|doi=10.1093/bja/aem325}}</ref><ref name="KitsonCarr2005">{{cite journal|last1=Kitson|first1=R.|last2=Carr|first2=B.|title=Tramadol and severe serotonin syndrome|journal=Anaesthesia|volume=60|issue=9|year=2005|pages=934–935|issn=0003-2409|doi=10.1111/j.1365-2044.2005.04345.x}}</ref><ref name="MousaviAminiahidashti2016">{{cite journal|last1=Mousavi|first1=SeyedJaber|last2=Aminiahidashti|first2=Hamed|last3=Shafiee|first3=Sajjad|last4=Hajiaghaei|first4=Gholamhossein|title=Tramadol Pill Alone May Cause Serotonin Syndrome|journal=Chinese Medical Journal|volume=129|issue=7|year=2016|pages=877|issn=0366-6999|doi=10.4103/0366-6999.178957}}</ref>}} or in combination) can produce serotonin syndrome. In recent years, the serotonin system has become a target of many types of drugs such as painkillers (tramadol), anti-anxiety medications (buspirone) and anti-psychotics (aripiprazole) as well as the obvious anti-depressant medications (fluoxetine). Also a common NDMA receptor antagonist in cough syrups in the [[Morphinans]] class of drugs ([[Dextromethorphan]]) at high doses has a possibility of causing serotonin syndrome.  With the increasing use of serotonin receptors as targets for a wide range of medication, it is becoming harder to predict medication's pharmacological profile and whether or not it has the potential to cause serotonin syndrome.