List Of Common Drugs That Can Cause Serotonin Syndrome
Serotonin syndrome, also called serotonin toxicity, is a potentially serious reaction usually caused by medications that increase serotonin. Too much serotonin can negatively affect the brain, muscles, and other parts of the body.
If you take different prescribed medications together, you may end up with too much serotonin in your body. The types of medication that could lead to serotonin syndrome include those used to treat depression and migraine, and manage pain.
Too much serotonin can cause a variety of mild to severe symptoms. These symptoms can affect the brain, muscles, and other parts of the body. Serotonin syndrome can occur if you take too much medication that boosts serotonin levels. Typically, the condition occurs when you combine two or more medications, illegal drugs, or nutritional supplements that increase serotonin levels.
How quickly do symptoms of serotonin syndrome develop?
From our previous article, Serotonin Syndrome Ruined My Life, studies have shown that symptoms usually begin within a few hours of taking a new medication that affects serotonin levels or increasing the dose of a drug you’re already taking. Nearly all people will experience symptoms within 24 hours of starting, adding, or increasing the dosage of a serotonergic medication or product.
Drugs That Cause Serotonin Syndrome
Here are 15 drugs that can cause serotonin syndrome:
- Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and citalopram (Celexa)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine (Pristiq)
- Monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Emsam)
- Tricyclic antidepressants (TCAs) such as amitriptyline (Elavil), nortriptyline (Pamelor), and imipramine (Tofranil)
- Lithium, a mood stabilizer
- Linezolid, an antibiotic
- Methamphetamine and other amphetamines
- MDMA (ecstasy) and other “club drugs”
- Dextromethorphan (DXM), a cough suppressant
- Triptans, a class of medications used to treat migraines, such as sumatriptan (Imitrex)
- St. John’s Wort, a natural supplement used for depression and anxiety
- Buspirone, an anti-anxiety medication
- Ondansetron, an anti-nausea medication
- Metoclopramide, a medication used to treat gastrointestinal disorders such as nausea and vomiting
- Methylene Blue, a medication used to treat methemoglobinemia (a blood disorder)
When taking any medication affecting serotonin, get to know the signs and symptoms of serotonin syndrome. Educate your family members as well, so they know what to look out for. There will be no confusion. You will not feel right once serotonin syndrome kicks in. Time is of the essence, so getting emergency medical help will help save your life.
How is serotonin syndrome treated?
Your treatment depends on the severity of your symptoms.
• Mild symptoms: If your symptoms are mild, stopping the medication or changing your dose usually makes symptoms go away within 24 to 72 hours. If your symptoms aren’t going away quickly, you may be given a serotonin blocker, such as cyproheptadine (Periactin®).
• Moderate symptoms: If your symptoms are moderate, you may be observed in the hospital for at least 24 hours to make sure your symptoms are improving with treatment.
• Severe symptoms: If your symptoms are severe, you’ll be admitted to the intensive care unit (ICU), where your body and organ function can be closely monitored.
Treatments, depending on your symptoms, may include:
• A sedative, such as benzodiazepine, to relieve such symptoms as agitation, muscle stiffness, and seizure-like movements.
• IV fluids to restore hydration and treat fever, and oxygen through a mask to improve oxygen levels in your blood.
• Medications to control heart rate and blood pressure.
• A breathing tube for mechanical ventilation, sedation, and muscle paralysis to reduce extremely high fever (106 Fahrenheit [41.1 Celsius]).
• Cyproheptadine, a serotonin-blocking agent, if other treatments aren’t working or aren’t working quickly enough.
If your case of serotonin syndrome was caused by an antidepressant, it may take several weeks for the medication to clear your body and for your symptoms to completely go away.
Don’t stop your medication or change your dose without talking to your healthcare provider first. However, if you have severe symptoms or your symptoms have worsened, seek emergency care. Serotonin syndrome can be life-threatening.
How to prevent serotonin syndrome
When getting any prescription, inform the healthcare professional about all the medications, over-the-counter drugs, and dietary supplements you take. If you add medications (whether prescription or OTC) or dietary supplements, inform the doctor first before you take them.
