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.