The serotonin toxidrome: shortfalls of current diagnostic criteria for related syndromes

References

• Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991;148(6):705–713.
   PubMed Web of Science ®Google Scholar
• Gillman PK. The serotonin syndrome and its treatment. J Psychopharmacol. 1999;13(1):100–109.
   PubMed Web of Science ®Google Scholar
• Gillman PK. Extracting value from case reports: lessons from serotonin toxicity. Anaesthesia. 2006;61(5):419–422.
   PubMed Web of Science ®Google Scholar
• Kroeze WK, Kristiansen K, Roth BL. Molecular biology of serotonin receptors structure and function at the molecular r level. Curr Top Med Chem. 2002;2(6):507–528.
   PubMedGoogle Scholar
• Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009;60:355–366.
   PubMed Web of Science ®Google Scholar
• Saper C. Brainstem modulation of sensation, movement, and consciousness. In: Kandel ER, Schwartz JH, Jessell TM, editors. Principles in neural science. 4th ed. New York, NY: McGraw-Hill; 2000.
   Google Scholar
• Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352(11):1112–1120.
   PubMed Web of Science ®Google Scholar
• Scotton WJ, Hill LJ, Williams AC, et al. Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions. Int J Tryptophan Res. 2019;12:1178646919873925.
   Web of Science ®Google Scholar
• Mignon L, Wolf WA. Postsynaptic 5-HT(1A) receptors mediate an increase in locomotor activity in the monoamine-depleted rat. Psychopharmacology. 2002;163(1):85–94.
   PubMed Web of Science ®Google Scholar
• Isbister GK, Buckley NA. The pathophysiology of serotonin toxicity in animals and humans: implications for diagnosis and treatment. Clin Neuropharmacol. 2005;28(5):205–214.
   PubMed Web of Science ®Google Scholar
• Nisijima K, Yoshino T, Ishiguro T. Risperidone counteracts lethality in an animal model of the serotonin syndrome. Psychopharmacology. 2000;150(1):9–14.
   PubMed Web of Science ®Google Scholar
• Nisijima K, Shioda K, Yoshino T, et al. Memantine, an NMDA antagonist, prevents the development of hyperthermia in an animal model for serotonin syndrome. Pharmacopsychiatry. 2004;37(2):57–62.
   PubMed Web of Science ®Google Scholar
• Shioda K, Nisijima K, Yoshino T, et al. Extracellular serotonin, dopamine and glutamate levels are elevated in the hypothalamus in a serotonin syndrome animal model induced by tranylcypromine and fluoxetine. Prog Neuropsychopharmacol Biol Psychiatry. 2004;28(4):633–640.
   PubMed Web of Science ®Google Scholar
• Nisijima K, Shioda K, Yoshino T, et al. Diazepam and chlormethiazole attenuate the development of hyperthermia in an animal model of the serotonin syndrome. Neurochem Int. 2003;43(2):155–164.
   PubMed Web of Science ®Google Scholar
• Rojas-Fernandez CH. Can 5-HT3 antagonists really contribute to serotonin toxicity? A call for clarity and pharmacological law and order . Drugs Real World Outcomes. 2014;1(1):3–5.
   PubMedGoogle Scholar
• Gillman PK. Triptans, serotonin agonists, and serotonin syndrome (serotonin toxicity): a review. Headache. 2010;50(2):264–272.
   PubMed Web of Science ®Google Scholar
• Baldo BA, Rose MA. The anaesthetist, opioid analgesic drugs, and serotonin toxicity: a mechanistic and clinical review. Br J Anaesth. 2020;124(1):44–62.
   PubMed Web of Science ®Google Scholar
• Frye JR, Poggemiller AM, McGonagill PW, et al. Use of cyproheptadine for the treatment of serotonin syndrome: a case series. J Clin Psychopharmacol. 2020;40(1):95–99.
   PubMed Web of Science ®Google Scholar
• Chan BS, Graudins A, Whyte IM, et al. Serotonin syndrome resulting from drug interactions. Med J Aust. 1998;169(10):523–525.
   PubMed Web of Science ®Google Scholar
• Dunkley EJ, Isbister GK, Sibbritt D, et al. The hunter serotonin toxicity criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96(9):635–642.
   PubMed Web of Science ®Google Scholar
• Evans RW. The FDA alert on serotonin syndrome with combined use of SSRIs or SNRIs and triptans: an analysis of the 29 case reports. MedGenMed. 2007;9(3):48.
   PubMedGoogle Scholar
• Roberto G, Piccinni C, D’Alessandro R, et al. Triptans and serious adverse vascular events: data mining of the FDA adverse event reporting system database. Cephalalgia. 2014;34(1):5–13.
   PubMed Web of Science ®Google Scholar
• Orlova Y, Rizzoli P, Loder E. Association of coprescription of triptan antimigraine drugs and selective serotonin reuptake inhibitor or selective norepinephrine reuptake inhibitor antidepressants with serotonin syndrome. JAMA Neurol. 2018;75(5):566–572.
   PubMed Web of Science ®Google Scholar
• Racz R, Soldatos TG, Jackson D, et al. Association between serotonin syndrome and second-generation antipsychotics via pharmacological target-adverse event analysis. Clin Transl Sci. 2018;11(3):322–329.
   PubMed Web of Science ®Google Scholar
• Isbister GK, Downes F, Whyte IM. Olanzapine and serotonin toxicity. Psychiatry Clin Neurosci. 2003;57(2):241–242.
   PubMed Web of Science ®Google Scholar
• Nisijima K, Yoshino T, Yui K, et al. Potent serotonin (5-HT)(2A) receptor antagonists completely prevent the development of hyperthermia in an animal model of the 5-HT syndrome. Brain Res. 2001;890(1):23–31.
   PubMed Web of Science ®Google Scholar
• Isbister GK. Comment: combination risperidone and SSRI-induced serotonin syndrome. Ann Pharmacother. 2003;37(10):1531–1532.
   PubMed Web of Science ®Google Scholar
• Balit CR, Isbister GK, Hackett LP, et al. Quetiapine poisoning: a case series. Ann Emerg Med. 2003;42(6):751–758.
   PubMed Web of Science ®Google Scholar
• Baldo BA. Opioid analgesic drugs and serotonin toxicity (syndrome): mechanisms, animal models, and links to clinical effects. Arch Toxicol. 2018;92(8):2457–2473.
   PubMed Web of Science ®Google Scholar
• Gillman PK. Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. Br J Anaesth. 2005;95(4):434–441.
   PubMed Web of Science ®Google Scholar
• Ryan NM, Isbister GK. Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely. Clin Toxicol. 2015;53(6):545–550.
   PubMed Web of Science ®Google Scholar
• Meyer JM, Cummings MA, Proctor G. Augmentation of phenelzine with aripiprazole and quetiapine in a treatment-resistant patient with psychotic unipolar depression: case report and literature review. CNS Spectr. 2017;22(5):391–396.
   PubMed Web of Science ®Google Scholar
• Diamond S. The use of sumatriptan in patients on monoamine oxidase inhibitors. Neurology. 1995;45(6):1039–1040.
   PubMed Web of Science ®Google Scholar
• Mason PJ, Morris VA, Balcezak TJ. Serotonin syndrome. Presentation of 2 cases and review of the literature. Medicine. 2000;79(4):201–209.
   PubMed Web of Science ®Google Scholar
• Buckley NA, Dawson AH, Isbister GK. Serotonin syndrome. BMJ. 2014;348:g1626.
   PubMed Web of Science ®Google Scholar
• Radomski JW, Dursun SM, Reveley MA, et al. An exploratory approach to the serotonin syndrome: an update of clinical phenomenology and revised diagnostic criteria. Med Hypotheses. 2000;55(3):218–224.
   PubMed Web of Science ®Google Scholar
• Nguyen CT, Xie L, Alley S, et al. Epidemiology and economic burden of serotonin syndrome with concomitant use of serotonergic agents: a retrospective study utilizing two large US claims databases. Prim Care Companion CNS Disord. 2017;19(6):17m02200.
   PubMedGoogle Scholar
• Kitamura S, Kawano T, Kaminaga S, et al. Effects of fentanyl on serotonin syndrome-like behaviors in rats. J Anesth. 2016;30(1):178–182.
   PubMed Web of Science ®Google Scholar
• Mackay FJ, Dunn NR, Mann RD. Antidepressants and the serotonin syndrome in general practice. Br J Gen Pract. 1999;49(448):871–874.
   PubMed Web of Science ®Google Scholar
• Isbister GK, Bowe SJ, Dawson A, et al. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol. 2004;42(3):277–285.
   PubMed Web of Science ®Google Scholar
• Isbister GK, Hackett LP, Dawson AH, et al. Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity. Br J Clin Pharmacol. 2003;56(4):441–450.
   PubMed Web of Science ®Google Scholar
• Hegerl U, Bottlender R, Gallinat J, et al. The serotonin syndrome scale: first results on validity. Eur Arch Psychiatry Clin Neurosci. 1998;248(2):96–103.
   PubMed Web of Science ®Google Scholar
• Kaneda Y, Ohmori T, Fujii A. The serotonin syndrome: investigation using the Japanese version of the serotonin syndrome scale. Psychiatry Res. 2001;105(1–2):135–142.
   PubMed Web of Science ®Google Scholar
• Bosnjak Kuharic D, Vukojevic J, Zaja N, et al. GHB roller-coaster: serotonin syndrome and withdrawal. Psychiatr Danub. 2019;31(3):371–373.
   PubMed Web of Science ®Google Scholar
• Isbister GK, Buckley NA, Whyte IM. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust. 2007;187(6):361–365.
   PubMed Web of Science ®Google Scholar
• Ronan GP, Ronan N, McGettigan S, et al. Serotonin syndrome unmasking thyrotoxicosis. BMJ Case Rep. 2019;12(3):e228404.
   PubMedGoogle Scholar
• Meegada S, Heda RP, Satapathy S, et al. Metoclopramide-induced serotonin syndrome. Cureus. 2019;11(12):e6359.
   PubMed Web of Science ®Google Scholar
• Romito JW, Turner ER, Rosener JA, et al. Baclofen therapeutics, toxicity, and withdrawal: a narrative review. SAGE Open Med. 2021;9:20503121211022197.
   Web of Science ®Google Scholar
• Wang RZ, Vashistha V, Kaur S, et al. Serotonin syndrome: preventing, recognizing, and treating it. Cleve Clin J Med. 2016;83(11):810–817.
   PubMed Web of Science ®Google Scholar
• Sutter R, Rüegg S, Kaplan PW. Epidemiology, diagnosis, and management of nonconvulsive status epilepticus: opening Pandora’s box. Neurol Clin Pract. 2012;2(4):275–286.
   PubMedGoogle Scholar
• Isbister GK, Dawson AH, Whyte IM. Comment: serotonin syndrome induced by fluvoxamine and mirtazapine. Ann Pharmacother. 2001;35(12):1674–1675.
   PubMed Web of Science ®Google Scholar
• Abdelfattah T, Abdel-Aziz Y, Khan Z, et al. Serotonin syndrome after administration of ondansetron during an esophagogastroduodenoscopy and balloon dilatation: 1813. Am J Gastroenterol. 2017;112:1689–1699.
   PubMed Web of Science ®Google Scholar
• Smischney NJ, Pollard EM, Nookala AU, et al. Serotonin syndrome in the perioperative setting. Am J Case Rep. 2018;19:833–835.
   PubMed Web of Science ®Google Scholar
• Kotani Y, Shimazawa M, Yoshimura S, et al. The experimental and clinical pharmacology of propofol, an anesthetic agent with neuroprotective properties. CNS Neurosci Ther. 2008;14(2):95–106.
   PubMed Web of Science ®Google Scholar
• Werneke U, Jamshidi F, Taylor DM, et al. Conundrums in neurology: diagnosing serotonin syndrome – a meta-analysis of cases. BMC Neurol. 2016;16:97.
   PubMed Web of Science ®Google Scholar
• Werneke U, Truedson-Martiniussen P, Wikström H, et al. Serotonin syndrome: a clinical review of current controversies. J Integr Neurosci. 2020;19(4):719–727.
   PubMed Web of Science ®Google Scholar
• Wikstrom H, Truedson P, Ott M, et al. Symptoms of severe serotonin syndrome – a pooled case analysis. J Psychosom Res. 2020;133:110042.
   Web of Science ®Google Scholar
• Parks V, Philipp AW, Raje S, et al. Concomitant blockade of 5-HT(1A) receptor and 5-HT transporter: use of the Hunter serotonin toxicity criteria in a clinical pharmacology study. Eur Neuropsychopharmacol. 2012;22(2):92–99.
   PubMed Web of Science ®Google Scholar
• Prakash S, Rathore C, Rana K, et al. Fatal serotonin syndrome: a systematic review of 56 cases in the literature. Clin Toxicol. 2021;59(2):89–100.
   PubMed Web of Science ®Google Scholar
• McIntyre IM, King CV, Staikos V, et al. A fatality involving moclobemide, sertraline, and pimozide. J Forensic Sci. 1997;42(5):951–953.
   PubMed Web of Science ®Google Scholar
• Lam F. Serotonin syndrome and death, possibly caused by moclobemide, sertraline and pimozide interaction. Brown Univ Psychopharmacol Update. 2003;14(5):2.
   Google Scholar
• Avarello TP, Cottone S. Serotonin syndrome: a reported case. Neurol Sci. 2002;23(Suppl 2):S55–S56.
   PubMedGoogle Scholar
• Karki SD, Masood GR. Combination risperidone and SSRI-induced serotonin syndrome. Ann Pharmacother. 2003;37(3):388–391.
   PubMed Web of Science ®Google Scholar
• Clark DB, Andrus MR, Byrd DC. Drug interactions between linezolid and selective serotonin reuptake inhibitors: case report involving sertraline and review of the literature. Pharmacotherapy. 2006;26(2):269–276.
   PubMed Web of Science ®Google Scholar
• Slettedal JK, Nilssen DO, Magelssen M, et al. Brain pathology in fatal serotonin syndrome: presentation of two cases. Neuropathology. 2011;31(3):265–270.
   PubMed Web of Science ®Google Scholar
• Dardis C, Omoregie E, Ly V. Fatal serotonin syndrome precipitated by oxcarbazepine in a patient using an selective serotonin reuptake inhibitor. Neurologist. 2012;18(4):204–205.
   PubMed Web of Science ®Google Scholar
• Benedetti MS. Enzyme induction and inhibition by new antiepileptic drugs: a review of human studies. Fundam Clin Pharmacol. 2000;14(4):301–319.
   PubMed Web of Science ®Google Scholar
• John S, Donnelly M, Uchino K. Catastrophic reversible cerebral vasoconstriction syndrome associated with serotonin syndrome. Headache. 2013;53:1482–1487.
   PubMed Web of Science ®Google Scholar
• Koekkoek W, Tjan D. The serotonin syndrome – a narrative review. Neth J Crit Care. 2017;25(3):94–98.
   Web of Science ®Google Scholar
• Alghamdi S, Seddeq Y, Algahtani H, et al. Fatal serotonin syndrome in a patient with Marchiafava-Bignami disease: combined neurological and psychiatric emergency. Neurol Neurochir Pol. 2018;52(2):277–280.
   PubMed Web of Science ®Google Scholar
• Ott M, Mannchen JK, Jamshidi F, et al. Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques. Ther Adv Psychopharmacol. 2019;9:2045125318818814.
   Web of Science ®Google Scholar
• Mueller PD, Korey WS. Death by “ecstasy”: the serotonin syndrome? Ann Emerg Med. 1998;32(3 Pt 1):377–380.
   PubMed Web of Science ®Google Scholar
• Hachem RY, Hicks K, Huen A, et al. Myelosuppression and serotonin syndrome associated with concurrent use of linezolid and selective serotonin reuptake inhibitors in bone marrow transplant recipients. Clin Infect Dis. 2003;37(1):e8–e11.
   PubMed Web of Science ®Google Scholar
• Batista M, Dugernier T, Simon M, et al. The spectrum of acute heart failure after venlafaxine overdose. Clin Toxicol. 2013;51(2):92–95.
   Web of Science ®Google Scholar
• Choudhry M. Serotonin syndrome and acute hyponatremia, complex overlapping syndromes, a case report and review. Clin Med Case Rep. 2014;03(02):92–96.
   Google Scholar
• Kraai EP, Seifert SA. Citalopram overdose: a fatal case. J Med Toxicol. 2015;11(2):232–236.
   PubMed Web of Science ®Google Scholar
• Troya J, Martínez de Gándara A, Ryan P, et al. Mephedrone and chemsex: when it stops being a party and becomes a fatal problem. Int J STD Aids. 2019;30(10):1028–1030.
   PubMed Web of Science ®Google Scholar
• Alibegović A, Kariž S, Volavšek M. Fatal overdose with a combination of SNRIs venlafaxine and duloxetine. Forensic Sci Med Pathol. 2019;15(2):258–261.
   PubMed Web of Science ®Google Scholar
• Nordstrom K, Vilke GM, Wilson MP. Psychiatric emergencies for clinicians: emergency department management of serotonin syndrome. J Emerg Med. 2016;50(1):89–91.
   PubMed Web of Science ®Google Scholar
• Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013;13(4):533–540.
   PubMedGoogle Scholar
• Power BM, Pinder M, Hackett LP, et al. Fatal serotonin syndrome following a combined overdose of moclobemide, clomipramine and fluoxetine. Anaesth Intensive Care. 1995;23(4):499–502.
   PubMed Web of Science ®Google Scholar
• Otte W, Birkenhager TK, van den Broek WW. Fatal interaction between tranylcypromine and imipramine. Eur Psychiatry. 2003;18(5):264–265.
   PubMed Web of Science ®Google Scholar
• Asusta HB, Keyser E, Dominguez P, et al. Serotonin syndrome in obstetrics: a case report and review of management. Mil Med. 2019;184(1–2):e284–e286.
   PubMed Web of Science ®Google Scholar
• Prakash S, Adroja B, Rathore C. Neuromuscular abnormalities in serotonin syndrome may be mistaken as seizure: a report and literature review. Neurol India. 2019;67(1):269–271.
   PubMed Web of Science ®Google Scholar
• van Oppen JD, Patel N, Tarique A. Hyperkinetic reaction to dihydrocodeine. BMJ Case Rep. 2020;13(1):e233264.
   PubMedGoogle Scholar
• Lim R, Arshad W. Underlying serotonin syndrome, masked by community-acquired pneumonia and myocardial ischemia. Am J Case Rep. 2020;21:e924109.
   PubMed Web of Science ®Google Scholar