Serotonin: Difference between revisions

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{{headerpanel|{{~~approval~~}}}}

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[[File:Serotonin.svg|300px|thumb|right|Skeletal formula of serotonin molecule.]]

[[File:Serotonin.svg|300px|thumb|right|Skeletal formula of a serotonin molecule.]]

'''Serotonin''', also known as '''5-hydroxytryptamine''' ('''5-HT'''), is a ~~[[monoamine]] [[neurotransmitter|neurotransmitter]] affecting the [[serotonin]] [[receptors]] (5-HT1-7). Serotonin is primarily~~ found in ~~the gastrointestinal tract~~, ~~platelets~~, and ~~in the central nervous system of animals including humans. It is popularly thought to be a contributor to feelings of well-being and happiness~~.

'''Serotonin''' (also known as '''5-hydroxytryptamine''', or '''5-HT'''), is a naturally occuring chemical found in humans, animals, and plants alike.

Approximately 90% of the human body's ~~total~~ serotonin is ~~located~~ in the ~~digestive system~~, where it ~~is used~~ to ~~regulate intestinal movements~~. ~~The remainder~~ is synthesized in serotonergic [[neurons]] of the CNS, ~~where it has various functions. These include~~ the regulation ~~of mood~~, ~~appetite~~, and ~~sleep~~. Serotonin also ~~has some cognitive functions~~, ~~including memory~~ and ~~learning~~. In the blood, it serves as a [[vasoconstriction|vasoconstrictor]], and could be attributed as the cause of vasoconstriction in most serotonergic drugs.

It exerts its effects through the [[monoamine]] [[neurotransmitter|neurotransmitters]] affecting the 14 known [[serotonin]] [[receptors]] (5-HT1A,1E,1F, 5-HT1Dα,1Dβ, 5-HT3,4,6,7, 5-HT2A,2B,2C, 5-HT5A-5B)<ref>{{cite book | vauthors=((Frazer, A.)), ((Hensler, J. G.)) | veditors=((Siegel, G. J.)) | date= 1999 | title=“Serotonin”. Basic neurochemistry: molecular, cellular, and medical aspects | publisher=Lippincott Williams & Wilkins | edition=6th ed | isbn=9780397518203}}</ref> 90%-95% of serotonin is located in the gastrointestinal tract, in blood platelets 8% and in the central nervous system 1%-2%.<ref>{{cite book | vauthors=((Kling, A.)) | date= 2013 | title=5-HT2A a serotonin receptor with a possible role in joint diseases | publisher=Ume Universitet | url=http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-64013 | isbn=9789174595499}}</ref>

It is commonly referred to as one of many "happy hormones" amongst dopamine, oxytocin, and endorphins, these chemicals bring about feelings of happiness and wellbeing (although this is a major oversimplification).

Approximately 95% of the human body's serotonin is produced in the intestines, where it has been credited with effects related to hormonal, autocrine, paracrine, and endocrine actions. <ref>{{cite book | vauthors=((Terry, N.)), ((Margolis, K. G.)) | veditors=((Greenwood-Van Meerveld, B.)) | date= 2017 | chapter=Gastrointestinal Pharmacology | title=Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance | publisher=Springer International Publishing | series=Handbook of Experimental Pharmacology | pages=319–342 | url=https://doi.org/10.1007/164_2016_103 | doi=10.1007/164_2016_103 | isbn=9783319563602}}</ref> What is not absorbed elsewhere in the body is synthesized into serotonergic [[neurons]] for use by the central nervous system or CNS, here the serotonergic neurons can regulate: sleep, appetite, sexual behavior, homeostasis/temperature regulation, pain, and cognition.

Serotonin also affects pathological states such as: disorders connected to mood, anxiety, psychosis and pain.<ref>{{cite journal | vauthors=((Chilmonczyk, Z.)), ((Bojarski, A.)), ((Pilc, A.)), ((Sylte, I.)) | journal=International Journal of Molecular Sciences | title=Functional Selectivity and Antidepressant Activity of Serotonin 1A Receptor Ligands | volume=16 | issue=8 | pages=18474–18506 | date=7 August 2015 | url=http://www.mdpi.com/1422-0067/16/8/18474 | issn=1422-0067 | doi=10.3390/ijms160818474}}</ref> Having either too little or too much serotonin can have many negative effects.

In the blood, it serves as a [[vasoconstriction|vasoconstrictor]], and could be attributed as the cause of vasoconstriction in most serotonergic drugs.{{citation needed}}

==Chemistry==

[[File:Indole_numbered.png|210px|thumb|right|Skeletal formula of indole molecule with ring positions numbered.]]

[[File:Monoamine_chain.png|210px|thumb|right|Skeletal formula of monoamine chain molecule.]]

Serotonin is comprised of a monoamine chain attached to an indole ring at the third carbon. A monoamine chain is made up of an amine group attached to an ethane chain. This monoamine chain can be found in many neurotransmitters, including [[histamine|histamine]], [[dopamine|dopamine]], [[adrenaline|adrenaline]] and [[noradrenaline|noradrenaline]]. It's also found in many drugs, examples being [[tryptamines]] and [[phenethylamines]].

Serotonin is comprised of a monoamine chain attached to an indole ring at the third carbon. A monoamine chain is made up of an amine group attached to an ethane chain.

==~~The~~ Serotonin ~~System~~==

This monoamine chain can be found in many neurotransmitters, including [[histamine|histamine]], [[dopamine|dopamine]], [[adrenaline|adrenaline]] and [[noradrenaline|noradrenaline]]. It is also found in many drugs, e.g. [[tryptamines]] and [[phenethylamines]].

Serotonin is synthesized from the α-amino acid tryptophan, which is hydroxylated into the metabolic intermediate [[5-Hydroxytryptophan]] (5-HTP) and then decarboxylated into serotonin. This process requires the co-enzyme vitamin B6.{{citation needed}}

==Serotonin system==

The serotonin receptor, or 5-HT receptors, are found throughout the central nervous system and the peripheral nervous system.

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A serotonin [[Agonist#Agonists|partial agonist]] is a drug that binds to and activates a serotonin receptor, but only has partial efficacy at the receptor relative to a full agonist.

Most classical psychedelic drugs are partial agonists of the 5-HT2A receptor; among them are [[LSD]], [[psilocin]] and [[mescaline]]. Many antidepressants, anxiolytics/anti-anxiety drugs, and cluster headache medicines are partial serotonin receptor agonists.

Most classical psychedelic drugs are partial agonists of the 5-HT2A receptor; among them are [[LSD]], [[psilocin]] and [[mescaline]].

Many antidepressants, anxiolytics/anti-anxiety drugs, and cluster headache medicines are partial serotonin receptor agonists.

====Inverse agonists====

A serotonin [[agonist#Inverse agonists |inverse agonist]] activates a serotonin receptor but has the opposite pharmacological effect. Inverse agonists trigger a specific response from a receptor, whereas antagonists inhibit the activity of the receptor.

Some antipsychotics such as ~~pimavanserin~~ are 5-HT2A inverse agonists. 5-HT2A inverse agonists have been researched for the treatment of insomnia with limited success.

Some antipsychotics such as Pimavanserin, Risperidone and Olanzapine are 5-HT2A inverse agonists. 5-HT2A inverse agonists have been researched for the treatment of insomnia with limited success.

====Releasing agents====

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A serotonin [[reuptake inhibitor]] inhibits the reabsorption of serotonin into the pre-synaptic neuron. Serotonin reuptake inhibitors do this by inhibiting the serotonin transporter, or SERT protein.

Many antidepressants such as venlafaxine (Effexor), citalopram (Celexa) and amitriptyline ~~are~~ serotonin reuptake inhibitors. Many recreational drugs like [[cocaine]] and [[tramadol]] are also serotonin reuptake inhibitors.

Many antidepressants such as: venlafaxine (Effexor), an SNRI, citalopram (Celexa), a SSRI and amitriptyline (Elavil), a TCA these antidepressants all exert there action through serotonin reuptake inhibitors. Many recreational drugs like [[cocaine]] and [[tramadol]] are also serotonin reuptake inhibitors.

====Antagonists====

A serotonin receptor [[antagonist]] is a type of receptor drug that inhibits action at serotonin receptors.

Many [[antipsychotics]] ~~like~~ [[haloperidol]] or [[quetiapine]] and anti-emetics are serotonin receptor antagonists. One example is galanolactone, a chemical found in ginger, that acts as an anti-emetic via its action as a 5-HT3 antagonist.

Many [[antipsychotics]] such as, [[haloperidol]] or [[quetiapine]] and anti-emetics are serotonin receptor antagonists. One example is galanolactone, a chemical found in ginger, that acts as an anti-emetic via its action as a 5-HT3 antagonist.

==Serotonin syndrome==

==Toxicity and harm potential==

~~''Main Article: [[Serotonin Syndrome~~|Serotonin ~~Syndrome]]''~~

===Serotonin syndrome===

Extremely high levels of serotonin can cause a condition known as serotonin syndrome ~~that has~~ toxic and potentially ~~fatal~~ effects. Serotonin syndrome, also known as serotonin toxicity, can be induced via overdose of particular drugs, drug interactions, and recreational drug use. Many drug interactions have been found to cause serotonin syndrome, the most notorious of which being the combination of an SSRI antidepressant and an [[MAOI]] antidepressant.

Extremely high levels of serotonin can cause a condition known as serotonin syndrome, which possess both toxic and potentially life threatening effects.

Symptoms can start showing within ~~minutes~~ and can include increased heart rate, sweating, anxiety, hyperthermia, shivering, high blood pressure, agitation, ~~seizures~~, and rarely death. Symptoms ~~usually~~ resolve ~~after 24 hours~~, ~~but can last up to several months~~ in ~~some~~ cases.

Serotonin syndrome, also known as serotonin toxicity, is not known to occur naturally without the introduction of a pharmaceutical or supplemental agent. However, serotonin syndrome is known to develop from naturally occurring compounds such as St. John's Wort, a treatment for depression, due to its similarities to already existing antidepressants. Excess amounts of serotonin in the brain is primarily caused by the concurrent use of two or more serotonin acting drugs.<ref>{{cite journal | vauthors=((Lane, R.)), ((Baldwin, D.)) | journal=Journal of Clinical Psychopharmacology | title=Selective Serotonin Reuptake Inhibitor-Induced Serotonin Syndrome: Review | volume=17 | issue=3 | pages=208–221 | date= June 1997 | url=http://journals.lww.com/00004714-199706000-00012 | issn=0271-0749 | doi=10.1097/00004714-199706000-00012}}</ref>

An example that may result in serotonin syndrome would include taking two antidepressants in combination such as Escitalopram (Lexapro) with Duloxetine (Cymbalta), since both drugs act on some of the same receptors they may cause serotonin syndrome.

Another example would be taking a prescription antidepressant in combination with an over the counter cough suppressant such as [[dextromethorphan]].<ref>{{cite journal | vauthors=((Monte, A. A.)), ((Chuang, R.)), ((Bodmer, M.)) | journal=British Journal of Clinical Pharmacology | title=Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review: Dextromethorphan, chlorphenamine and serotonin toxicity | volume=70 | issue=6 | pages=794–798 | date= December 2010 | url=https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2010.03747.x | issn=03065251 | doi=10.1111/j.1365-2125.2010.03747.x}}</ref><ref>{{cite journal | vauthors=((Schwartz, A. R.)), ((Pizon, A. F.)), ((Brooks, D. E.)) | journal=Clinical Toxicology | title=Dextromethorphan-induced serotonin syndrome | volume=46 | issue=8 | pages=771–773 | date= January 2008 | url=http://www.tandfonline.com/doi/full/10.1080/15563650701668625 | issn=1556-3650 | doi=10.1080/15563650701668625}}</ref>The number of possibly dangerous combinations are numerous. If you are currently taking an antidepressant or are considering taking a new substance, ensure that no dangerous interactions exist.

Symptoms can start showing within hours and can include: increased or irregular heart rate, tremors, low-grade fever to fevers at or over 41°C (105.8°F), sweating, anxiety, hyperthermia, shivering, high blood pressure, restlessness, dilation of the pupils, overactive or over responsive reflexes, agitation, confusion, death of muscle fibers, clotting of small blood vessels, increase in body acidity, delirium, renal (kidney) failure, coma and rarely death.<ref>{{cite journal | vauthors=((Frank, C.)) | journal=Canadian Family Physician | title=Recognition and treatment of serotonin syndrome | volume=54 | issue=7 | pages=988–992 | date=1 July 2008 | url=https://www.cfp.ca/content/54/7/988 | issn=0008-350X}}</ref>

Symptoms in minor cases may resolves within days, moderate cases may resolve within weeks, and in severe cases permanent damage or death may occur.

==See also==

*[[Responsible use]]

*[[~~Acetylcholine~~]]

*[[Neurotransmitter]]

*[[Dopamine]]

*[[Glutamate]]

*[[Adrenaline]]

*[[Noradrenaline]]

*[[~~GABA~~]]

*[[5-HTP]]

*[[~~Neurotransmitter~~]]

==External links==

*[https://en.wikipedia.org/wiki/Serotonin Serotonin (Wikipedia)]

*[https://en.wikipedia.org/wiki/Tryptophan Tryptophan (Wikipedia)]

*[https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-Hydroxytryptophan (Wikipedia)]

*[https://isomerdesign.com/PiHKAL/explore.php?id=5128 Serotonin (Isomer Design)]

==Literature==

*Sodhi, M., & Sanders-Bush, E. (2004). Serotonin and brain development. International Review of Neurobiology, 59, 111-74. https://doi.org/10.1016/S0074-7742(04)59006-2

*Nichols, D.E., & Nichols, C.D. (2008). Serotonin receptors. Chemical Reviews, 108 5, 1614-41. https://doi.org/10.1021/cr078224o

*Berger, M., Gray, J.A., & Roth, B.L. (2009). The expanded biology of serotonin. Annual Review of Medicine, 60, 355-66. https://doi.org/10.1146/annurev.med.60.042307.110802

*Aghajanian, G., & Marek, G. (1999). Serotonin and Hallucinogens. Neuropsychopharmacology, 21, 16S-23S. https://doi.org/10.1016/S0893-133X(98)00135-3

==References==

[[Category:~~Neurotransmitters~~]]

[[Category:Neurotransmitter]]

[[Category:Tryptamine]]

@@ Line 1: / Line 1: @@
-{{headerpanel|{{approval}}}}
+{{headerpanel|{{stub}}}}
-[[File:Serotonin.svg|300px|thumb|right|Skeletal formula of serotonin molecule.]]
+[[File:Serotonin.svg|300px|thumb|right|Skeletal formula of a serotonin molecule.]]
-'''Serotonin''', also known as '''5-hydroxytryptamine''' ('''5-HT'''), is a [[monoamine]] [[neurotransmitter|neurotransmitter]] affecting the [[serotonin]] [[receptors]] (5-HT<sub>1-7</sub>). Serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans. It is popularly thought to be a contributor to feelings of well-being and happiness.
+'''Serotonin''' (also known as '''5-hydroxytryptamine''', or '''5-HT'''), is a naturally occuring chemical found in humans, animals, and plants alike.
-Approximately 90% of the human body's total serotonin is located in the digestive system, where it is used to regulate intestinal movements. The remainder is synthesized in serotonergic [[neurons]] of the CNS, where it has various functions. These include the regulation of mood, appetite, and sleep. Serotonin also has some cognitive functions, including memory and learning. In the blood, it serves as a [[vasoconstriction|vasoconstrictor]], and could be attributed as the cause of vasoconstriction in most serotonergic drugs.
+It exerts its effects through the [[monoamine]] [[neurotransmitter|neurotransmitters]] affecting the 14 known [[serotonin]] [[receptors]] (5-HT<sub>1A,1E,1F</sub>, 5-HT<sub>1Dα,1Dβ</sub>, 5-HT<sub>3,4,6,7</sub>, 5-HT<sub>2A,2B,2C</sub>, 5-HT<sub>5A-5B</sub>)<ref>{{cite book | vauthors=((Frazer, A.)), ((Hensler, J. G.)) | veditors=((Siegel, G. J.)) | date= 1999 | title=“Serotonin”. Basic neurochemistry: molecular, cellular, and medical aspects | publisher=Lippincott Williams & Wilkins | edition=6th ed | isbn=9780397518203}}</ref> 90%-95% of serotonin is located in the gastrointestinal tract, in blood platelets 8% and in the central nervous system 1%-2%.<ref>{{cite book | vauthors=((Kling, A.)) | date= 2013 | title=5-HT2A a serotonin receptor with a possible role in joint diseases | publisher=Ume Universitet | url=http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-64013 | isbn=9789174595499}}</ref>
+It is commonly referred to as one of many "happy hormones" amongst dopamine, oxytocin, and endorphins, these chemicals bring about feelings of happiness and wellbeing (although this is a major oversimplification).
+Approximately 95% of the human body's serotonin is produced in the intestines, where it has been credited with effects related to hormonal, autocrine, paracrine, and endocrine actions. <ref>{{cite book | vauthors=((Terry, N.)), ((Margolis, K. G.)) | veditors=((Greenwood-Van Meerveld, B.)) | date= 2017 | chapter=Gastrointestinal Pharmacology | title=Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance | publisher=Springer International Publishing | series=Handbook of Experimental Pharmacology | pages=319–342 | url=https://doi.org/10.1007/164_2016_103 | doi=10.1007/164_2016_103 | isbn=9783319563602}}</ref> What is not absorbed elsewhere in the body is synthesized into serotonergic [[neurons]] for use by the central nervous system or CNS, here the serotonergic neurons can regulate: sleep, appetite, sexual behavior, homeostasis/temperature regulation, pain, and cognition.
+Serotonin also affects pathological states such as: disorders connected to mood, anxiety, psychosis and pain.<ref>{{cite journal | vauthors=((Chilmonczyk, Z.)), ((Bojarski, A.)), ((Pilc, A.)), ((Sylte, I.)) | journal=International Journal of Molecular Sciences | title=Functional Selectivity and Antidepressant Activity of Serotonin 1A Receptor Ligands | volume=16 | issue=8 | pages=18474–18506 | date=7 August 2015 | url=http://www.mdpi.com/1422-0067/16/8/18474 | issn=1422-0067 | doi=10.3390/ijms160818474}}</ref> Having either too little or too much serotonin can have many negative effects.
+In the blood, it serves as a [[vasoconstriction|vasoconstrictor]], and could be attributed as the cause of vasoconstriction in most serotonergic drugs.{{citation needed}}
 ==Chemistry==
 [[File:Indole_numbered.png|210px|thumb|right|Skeletal formula of indole molecule with ring positions numbered.]]
 [[File:Monoamine_chain.png|210px|thumb|right|Skeletal formula of monoamine chain molecule.]]
-Serotonin is comprised of a monoamine chain attached to an indole ring at the third carbon. A monoamine chain is made up of an amine group attached to an ethane chain. This monoamine chain can be found in many neurotransmitters, including [[histamine|histamine]], [[dopamine|dopamine]], [[adrenaline|adrenaline]] and [[noradrenaline|noradrenaline]]. It's also found in many drugs, examples being [[tryptamines]] and [[phenethylamines]].
+Serotonin is comprised of a monoamine chain attached to an indole ring at the third carbon. A monoamine chain is made up of an amine group attached to an ethane chain.
-==The Serotonin System==
+This monoamine chain can be found in many neurotransmitters, including [[histamine|histamine]], [[dopamine|dopamine]], [[adrenaline|adrenaline]] and [[noradrenaline|noradrenaline]]. It is also found in many drugs, e.g. [[tryptamines]] and [[phenethylamines]].
+Serotonin is synthesized from the α-amino acid tryptophan, which is hydroxylated into the metabolic intermediate [[5-Hydroxytryptophan]] (5-HTP) and then decarboxylated into serotonin. This process requires the co-enzyme vitamin B6.{{citation needed}}
+==Serotonin system==
 {{stub}}
 The serotonin receptor, or 5-HT receptors, are found throughout the central nervous system and the peripheral nervous system.
@@ Line 22: / Line 34: @@
 A serotonin [[Agonist#Agonists|partial agonist]] is a drug that binds to and activates a serotonin receptor, but only has partial efficacy at the receptor relative to a full agonist.
-Most classical psychedelic drugs are partial agonists of the 5-HT<sub>2A</sub> receptor; among them are [[LSD]], [[psilocin]] and [[mescaline]]. Many antidepressants, anxiolytics/anti-anxiety drugs, and cluster headache medicines are partial serotonin receptor agonists.
+Most classical psychedelic drugs are partial agonists of the 5-HT<sub>2A</sub> receptor; among them are [[LSD]], [[psilocin]] and [[mescaline]].
+Many antidepressants, anxiolytics/anti-anxiety drugs, and cluster headache medicines are partial serotonin receptor agonists.
 ====Inverse agonists====
 A serotonin [[agonist#Inverse agonists |inverse agonist]] activates a serotonin receptor but has the opposite pharmacological effect. Inverse agonists trigger a specific response from a receptor, whereas antagonists inhibit the activity of the receptor.
-Some antipsychotics such as pimavanserin are 5-HT<sub>2A</sub> inverse agonists. 5-HT<sub>2A</sub> inverse agonists have been researched for the treatment of insomnia with limited success.
+Some antipsychotics such as Pimavanserin, Risperidone and Olanzapine are 5-HT<sub>2A</sub> inverse agonists. 5-HT<sub>2A</sub> inverse agonists have been researched for the treatment of insomnia with limited success.
 ====Releasing agents====
@@ Line 37: / Line 51: @@
 A serotonin [[reuptake inhibitor]] inhibits the reabsorption of serotonin into the pre-synaptic neuron. Serotonin reuptake inhibitors do this by inhibiting the serotonin transporter, or SERT protein.
-Many antidepressants such as venlafaxine (Effexor), citalopram (Celexa) and amitriptyline are serotonin reuptake inhibitors. Many recreational drugs like [[cocaine]] and [[tramadol]] are also serotonin reuptake inhibitors.
+Many antidepressants such as: venlafaxine (Effexor), an SNRI, citalopram (Celexa), a SSRI and amitriptyline (Elavil), a TCA these antidepressants all exert there action through serotonin reuptake inhibitors. Many recreational drugs like [[cocaine]] and [[tramadol]] are also serotonin reuptake inhibitors.
 ====Antagonists====
 A serotonin receptor [[antagonist]] is a type of receptor drug that inhibits action at serotonin receptors.
-Many [[antipsychotics]] like [[haloperidol]] or [[quetiapine]] and anti-emetics are serotonin receptor antagonists. One example is galanolactone, a chemical found in ginger, that acts as an anti-emetic via its action as a 5-HT<sub>3</sub> antagonist.
+Many [[antipsychotics]] such as, [[haloperidol]] or [[quetiapine]] and anti-emetics are serotonin receptor antagonists. One example is galanolactone, a chemical found in ginger, that acts as an anti-emetic via its action as a 5-HT<sub>3</sub> antagonist.
-==Serotonin syndrome==
+==Toxicity and harm potential==
-''Main Article: [[Serotonin Syndrome|Serotonin Syndrome]]''
+{{toxicity}}
+===Serotonin syndrome===
+{{main|Serotonin syndrome}}
-Extremely high levels of serotonin can cause a condition known as serotonin syndrome that has toxic and potentially fatal effects. Serotonin syndrome, also known as serotonin toxicity, can be induced via overdose of particular drugs, drug interactions, and recreational drug use. Many drug interactions have been found to cause serotonin syndrome, the most notorious of which being the combination of an SSRI antidepressant and an [[MAOI]] antidepressant.
+Extremely high levels of serotonin can cause a condition known as serotonin syndrome, which possess both toxic and potentially life threatening effects.
-Symptoms can start showing within minutes and can include increased heart rate, sweating, anxiety, hyperthermia, shivering, high blood pressure, agitation, seizures, and rarely death. Symptoms usually resolve after 24 hours, but can last up to several months in some cases.
+Serotonin syndrome, also known as serotonin toxicity, is not known to occur naturally without the introduction of a pharmaceutical or supplemental agent. However, serotonin syndrome is known to develop from naturally occurring compounds such as St. John's Wort, a treatment for depression, due to its similarities to already existing antidepressants. Excess amounts of serotonin in the brain is primarily caused by the concurrent use of two or more serotonin acting drugs.<ref>{{cite journal | vauthors=((Lane, R.)), ((Baldwin, D.)) | journal=Journal of Clinical Psychopharmacology | title=Selective Serotonin Reuptake Inhibitor-Induced Serotonin Syndrome: Review | volume=17 | issue=3 | pages=208–221 | date= June 1997 | url=http://journals.lww.com/00004714-199706000-00012 | issn=0271-0749 | doi=10.1097/00004714-199706000-00012}}</ref>
+An example that may result in serotonin syndrome would include taking two antidepressants in combination such as Escitalopram (Lexapro) with Duloxetine (Cymbalta), since both drugs act on some of the same receptors they may cause serotonin syndrome.
+Another example would be taking a prescription antidepressant in combination with an over the counter cough suppressant such as [[dextromethorphan]].<ref>{{cite journal | vauthors=((Monte, A. A.)), ((Chuang, R.)), ((Bodmer, M.)) | journal=British Journal of Clinical Pharmacology | title=Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review: Dextromethorphan, chlorphenamine and serotonin toxicity | volume=70 | issue=6 | pages=794–798 | date= December 2010 | url=https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2010.03747.x | issn=03065251 | doi=10.1111/j.1365-2125.2010.03747.x}}</ref><ref>{{cite journal | vauthors=((Schwartz, A. R.)), ((Pizon, A. F.)), ((Brooks, D. E.)) | journal=Clinical Toxicology | title=Dextromethorphan-induced serotonin syndrome | volume=46 | issue=8 | pages=771–773 | date= January 2008 | url=http://www.tandfonline.com/doi/full/10.1080/15563650701668625 | issn=1556-3650 | doi=10.1080/15563650701668625}}</ref>The number of possibly dangerous combinations are numerous. If you are currently taking an antidepressant or are considering taking a new substance, ensure that no dangerous interactions exist.
+Symptoms can start showing within hours and can include: increased or irregular heart rate, tremors, low-grade fever to fevers at or over 41°C (105.8°F), sweating, anxiety, hyperthermia, shivering, high blood pressure, restlessness, dilation of the pupils, overactive or over responsive reflexes, agitation, confusion, death of muscle fibers, clotting of small blood vessels, increase in body acidity, delirium, renal (kidney) failure, coma and rarely death.<ref>{{cite journal | vauthors=((Frank, C.)) | journal=Canadian Family Physician | title=Recognition and treatment of serotonin syndrome | volume=54 | issue=7 | pages=988–992 | date=1 July 2008 | url=https://www.cfp.ca/content/54/7/988 | issn=0008-350X}}</ref>
+Symptoms in minor cases may resolves within days, moderate cases may resolve within weeks, and in severe cases permanent damage or death may occur.
 ==See also==
 *[[Responsible use]]
-*[[Acetylcholine]]
+*[[Neurotransmitter]]
 *[[Dopamine]]
-*[[Glutamate]]
 *[[Adrenaline]]
 *[[Noradrenaline]]
-*[[GABA]]
+*[[5-HTP]]
-*[[Neurotransmitter]]
+==External links==
+*[https://en.wikipedia.org/wiki/Serotonin Serotonin (Wikipedia)]
+*[https://en.wikipedia.org/wiki/Tryptophan Tryptophan (Wikipedia)]
+*[https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-Hydroxytryptophan (Wikipedia)]
+*[https://isomerdesign.com/PiHKAL/explore.php?id=5128 Serotonin (Isomer Design)]
+==Literature==
+*Sodhi, M., & Sanders-Bush, E. (2004). Serotonin and brain development. International Review of Neurobiology, 59, 111-74. https://doi.org/10.1016/S0074-7742(04)59006-2
+*Nichols, D.E., & Nichols, C.D. (2008). Serotonin receptors. Chemical Reviews, 108 5, 1614-41. https://doi.org/10.1021/cr078224o
+*Berger, M., Gray, J.A., & Roth, B.L. (2009). The expanded biology of serotonin. Annual Review of Medicine, 60, 355-66. https://doi.org/10.1146/annurev.med.60.042307.110802
+*Aghajanian, G., & Marek, G. (1999). Serotonin and Hallucinogens. Neuropsychopharmacology, 21, 16S-23S. https://doi.org/10.1016/S0893-133X(98)00135-3
 ==References==
-{{references}}
+<references />
-[[Category:Neurotransmitters]]
+[[Category:Neurotransmitter]]
+[[Category:Tryptamine]]
+{{#set:Featured=true}}