1. Introduction
Serotonin syndrome is a syndrome - or drug toxidrome - precipitated by the use of serotonergic drugs, leading to excessive activation of both central and peripheral serotonin postsynaptic receptors. As a consequence, patients with serotonin syndrome experience varieties of altered mental status, autonomic hyperactivity and neuromuscular aberrations with risk of fatal outcomes 1–5.
Many drugs – be it in therapeutic doses, overdoses, intoxications or as a complex drug interaction between two or more serotonergic agents – can result in serotonin syndrome. At the same time, the actual incidence of serotonin syndrome is unknown due to its diffuse clinical presentation. As a result, serotonin syndrome is often not recognized or formally diagnosed 4.
The objective of this review is to enhance clinicians’ awareness of serotonin syndrome by providing an overview of the condition with an emphasis on serotonergic drugs and their impact on serotonergic pathways as this knowledge is essential for detecting as well as managing the syndrome.