[Serotonin syndrome: report of two cases and review of the literature]

Rev Neurol. 2005 Feb;40(3):159-62.
[Article in Spanish]

Abstract

Introduction: Serotonin is a neurotransmitter synthesized from tryptophan. It is implied in the regulation of mood, cognition, sleep cycle, synthesis of cerebrospinal fluid, and other processes. Generally, it is implied in human pathology by hypofunction. However, there is a complication of unknown incidence related to treatment with drugs that increase the stimulation of 5-HT1A serotonin receptors, called serotonin syndrome (SS). Clinically, it is characterised by the presence of a triad of mental and autonomic disorders, and motor hyperactivity. This entity has not biological markers and its diagnosis could be done verifying the proposed criteria.

Case reports: Two cases of SS are presented, one of them related to the combination of risperidone and sertraline, as first report in the literature. Both cases had a favourable outcome employing support measures.

Conclusions: The physiopathology, the diagnosis, the differential diagnosis, and the treatment are reviewed. We emphasize the potentially high frequency of this disorder, given the growing use of serotonin activity modifying drugs, and the typically benign course of the SS once the support measures are started.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Drug Therapy, Combination
  • Humans
  • Male
  • Middle Aged
  • Neurons / chemistry
  • Neurons / metabolism
  • Risperidone / adverse effects
  • Risperidone / therapeutic use
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Serotonin / metabolism
  • Serotonin Antagonists / adverse effects
  • Serotonin Antagonists / therapeutic use
  • Serotonin Syndrome / diagnosis*
  • Serotonin Syndrome / drug therapy
  • Serotonin Syndrome / physiopathology*
  • Sertraline / adverse effects
  • Sertraline / therapeutic use
  • Treatment Outcome

Substances

  • Serotonin Antagonists
  • Serotonin Uptake Inhibitors
  • Serotonin
  • Risperidone
  • Sertraline