Serotonin syndrome is a potentially life-threatening condition caused by the adverse effect of serotonergic drugs or drug interactions on the central nervous system. There is a long list of illicit drugs, supplements, and medications that can cause serotonin syndrome either alone or in combination with each other. The most common medications involved are selective serotonin reuptake inhibitors (SSRIs), particularly after an overdose or in combination with a monoamine oxidase (MAO) inhibitor. Serotonin syndrome occurs in approximately 15% of individuals who overdose on an SSRI but has been reported in patients taking therapeutic doses of only one serotonergic medication.
Individuals in any age group can develop serotonin syndrome. Onset of symptoms is usually within 6 hours from the time the offending medication was ingested. Signs and symptoms of more severe cases usually include a combination of mental status changes, autonomic instability, and hyperreflexia or clonus.
Management includes immediate discontinuation of the serotonergic medication, addressing abnormal vital signs, administering serotonin antagonists, and sedation. The prognosis for recovery is very good with early administration of supportive care.
ICD10CM: G25.89 – Other specified extrapyramidal and movement disorders
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.