The Serotonin Syndrome

International Union of Pharmacology classification of receptors for 5-hydroxytryptamine (Serotonin).

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The serotonin syndrome

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The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity

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Neuroleptic malignant syndrome

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Interactions Between Herbal Medicines and Prescribed Drugs

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Relative Toxicity of Selective Serotonin Reuptake Inhibitors (SSRIs) in Overdose

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The Libby Zion Case

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Effects of Exposure to Selective Serotonin Reuptake Inhibitors During Pregnancy on Serotonergic Symptoms in Newborns and Cord Blood Monoamine and Prolactin Concentrations

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Recreational Ecstasy/MDMA, the serotonin syndrome, and serotonergic neurotoxicity

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Tramadol overdose: review of the literature

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Serotonin toxicity precipitated by concomitant use of citalopram and methylene blue

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Using evolutionary tools to search for novel psychoactive plants

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Cardiovascular side effects of newer antidepressants.

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Fibromyalgia: Should the treatment paradigm be monotherapy or combination pharmacotherapy?

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Reported Cases of Serotonin Syndrome in MDMA Users in FAERS Database

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Depression

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The value of Genus Acacia in arid and semi-arid environments for the treatment of chronic inflammatory diseases

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Role of the circadian nuclear receptor REV-ERBα in dorsal raphe serotonin synthesis in mood regulation

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Considerations in the Treatment of Geriatric Depression

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3-[5-(4,5-Dihydro-1H-imidazol-2-yl)-furan-2-yl]phenylamine (Amifuraline), a Promising Reversible and Selective Peripheral MAO-A Inhibitor

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Serotonin Syndrome Associated With Citalopram and Meperidine

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Medical Complications of Psychiatric Treatment

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The antimalarial drug quinine interferes with serotonin biosynthesis and action

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Neuroleptic Malignant Syndrome Versus Serotonin Syndrome: The Search for a Diagnostic Tool

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A Case Report of Serotonin Syndrome in a Patient on Selective Serotonin Reuptake Inhibitor (SSRI) Monotherapy

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Methylene blue inhibits function of the 5‐HT transporter

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Rhabdomyolysis, acute renal failure, and cardiac arrest secondary to status dystonicus in a child with glutaric aciduria type I

Jamuar, S. S., Newton, S. A., Prabhu, S. P., Hecht, L. E., Costas, K. C., Wessel, A. E., Harris, D. J., Anselm, I. A., & Berry, G. T. (2012) · Molecular Genetics and Metabolism · doi:10.1016/j.ymgme.2012.05.018 · Cited by 20

Lack of clinically significant interactions between concomitantly administered rasagiline and escitalopram

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Dyskinesias associated with atomoxetine in combination with other psychoactive drugs

Bond, G. R., Garro, A. C., & Gilbert, D. L. (2007) · Clinical Toxicology · doi:10.1080/15563650600981178 · Cited by 20

The failure of anxiolytic therapies in early clinical trials: what needs to be done

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Emergency presentations of Parkinson's disease: early recognition and treatment are crucial for optimum outcome

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Sertraline and periodic limb movements during sleep: an 8-week open-label study in depressed patients with insomnia

Zhang, B., Hao, Y., Jia, F., Li, X., Ren, Y., Zhou, P., Liu, W., & Wing, Y. K. (2013) · Sleep Medicine · doi:10.1016/j.sleep.2013.07.019 · Cited by 20

Dexmedetomidine in the Treatment of Serotonin Syndrome

Rushton, W. F., & Charlton, N. P. (2014) · Annals of Pharmacotherapy · doi:10.1177/1060028014549184 · Cited by 20

Effects of Hypericum perforatum extract and its main bioactive compounds on the cytotoxicity and expression of CYP1A2 and CYP2D6 in hepatic cells

Silva, S. M., Martinho, A., Moreno, I., Silvestre, S., Breitenfeld, L., Alves, G., Duarte, A. P., Domingues, F., & Gallardo, E. (2015) · Life Sciences · doi:10.1016/j.lfs.2015.11.004 · Cited by 20

Serotoninsyndrom und medikamentöse Schmerztherapie

Schenk, M., & Wirz, S. (2015) · Der Schmerz · doi:10.1007/s00482-015-1512-0 · Cited by 20

Ecstasy (MDMA) and its effects on kidneys and their treatment: a review.

Bora, F., Yılmaz, F., & Bora, T. (2016) · PubMed Central · doi:10.22038/ijbms.2016.7813 · Cited by 20

Serotonin syndrome in a patient taking Lexapro and Flexeril: a case report

Day, L. T., & Jeanmonod, R. (2008) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2008.03.028 · Cited by 20

Recognizing Serotonin Toxicity in the Pediatric Emergency Department

Kant, S., & Liebelt, E. L. (2012) · Pediatric Emergency Care · doi:10.1097/pec.0b013e31826289d9 · Cited by 19

Drugs of Abuse—Opioids, Sedatives, Hypnotics

Azevedo, K., Johnson, M., Wassermann, M., & Evans-Wall, J. (2021) · Critical Care Clinics · doi:10.1016/j.ccc.2021.03.003 · Cited by 19

Predicting serotonin toxicity in serotonin reuptake inhibitor overdose

Cooper, J. M., Duffull, S. B., & Isbister, G. K. (2022) · Clinical Toxicology · doi:10.1080/15563650.2022.2151455 · Cited by 19

The current state of ayahuasca research in animal models: A systematic review

Daldegan‐Bueno, D., Simionato, N. M., Favaro, V. M., & Maia, L. O. (2023) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2023.110738 · Cited by 21

Linezolid-Induced Near-Fatal Serotonin Syndrome During Escitalopram Therapy: Case Report and Review of Literature

Kulkarni, R. R., & Kulkarni, P. R. (2013) · Indian Journal of Psychological Medicine · doi:10.4103/0253-7176.122245 · Cited by 19

Prenatal Cocaine Disrupts Serotonin Signaling-Dependent Behaviors:Implications for Sex Differences, Early Stress and Prenatal SSRI Exposure

Williams, S. K., Lauder, J. M., & Johns, J. M. (2011) · Current Neuropharmacology · doi:10.2174/157015911796557957 · Cited by 18

Serotonin syndrome associated with polypharmacy in the elderly

Poeschla, B., Bartle, P., & Hansen, K. P. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.11.015 · Cited by 19

Genetics of Depression: An Overview of the Current Science

Elder, B. L., & Mosack, V. (2011) · Issues in Mental Health Nursing · doi:10.3109/01612840.2010.541588 · Cited by 24

Pharmacotherapeutic options for the treatment of depression in patients with chronic kidney disease.

Raymond, C. B., Wazny, L. D., & Honcharik, P. L. (2008) · PubMed · Cited by 19

Dietary tryptophan supplementation and affective state in pigs

Stracke, J., Otten, W., Tuchscherer, A., Witthahn, M., Metges, C. C., Puppe, B., & Düpjan, S. (2017) · Journal of Veterinary Behavior · doi:10.1016/j.jveb.2017.03.009 · Cited by 18

Implications of Off‐Target Serotoninergic Drug Activity: An Analysis of Serotonin Syndrome Reports Using a Systematic Bioinformatics Approach

Culbertson, V. L., Rahman, S. E., Bosen, G. C., Caylor, M. L., Echevarria, M. M., & Xu, D. Q. (2018) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.2163 · Cited by 20

Chronic serotonin syndrome: A retrospective study

Prakash, S., Rathore, C., Rana, K., Roychowdhury, D., & Lodha, D. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i4.124 · Cited by 19

Fluoxetine overdose in a teenager resulting in serotonin syndrome, seizure and delayed onset rhabdomyolysis

Lee‐Kelland, R., Zehra, S., & Mappa, P. (2018) · BMJ Case Reports · doi:10.1136/bcr-2018-225529 · Cited by 19

Behavioral effects of dipropyltryptamine in rats: evidence for 5-HT1A and 5-HT2A agonist activity

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Serotonin syndrome and rhabdomyolysis in venlafaxine poisoning: a case report.

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Seizures during antidepressant treatment in psychiatric inpatients—results from the transnational pharmacovigilance project “Arzneimittelsicherheit in der Psychiatrie” (AMSP) 1993–2008

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Psychiatric Neuroethics

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The effect of fluoxetine on penicillin-induced epileptiform activity

Aygün, H. (2019) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2019.03.050 · Cited by 18

How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis

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Real-world evaluation of linezolid-associated serotonin toxicity with and without concurrent serotonergic agents

Kufel, W. D., Parsels, K. A., Blaine, B. E., Steele, J. M., Seabury, R. W., & Asiago‐Reddy, E. (2023) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2023.106843 · Cited by 18

Serotonin syndrome: An often-neglected medical emergency

Badar, A. (2024) · Journal of Family and Community Medicine · doi:10.4103/jfcm.jfcm_236_23 · Cited by 20

Inpatient Management of Hyperemesis Gravidarum

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Advances in molecular mechanisms and therapeutic strategies for central nervous system diseases based on gut microbiota imbalance

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Recognition and management of perioperative serotonin syndrome

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Cows Come Down from the Mountains before the (Mw = 6.1) Earthquake Colfiorito in September 1997; A Single Case Study

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A comparison of midazolam and dexmedetomidine for the recovery of serotonin syndrome in rats

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Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine

Bazzan, A. J., Zabrecky, G. P., Monti, D., & Newberg, A. B. (2014) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2014.892420 · Cited by 18

Toxidrome-based Approach to Common Poisonings

Mégarbane, B. (2014) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.22038/apjmt.2014.2463 · Cited by 18

Headache as a presenting feature in patients with serotonin syndrome: A case series

Prakash, S., Belani, P., & Trivedi, A. M. (2013) · Cephalalgia · doi:10.1177/0333102413495968 · Cited by 18

Serotonin Syndrome in Tapentadol Literature: Systematic Review of Original Research

Gressler, L. E., Hammond, D. A., & Painter, J. T. (2017) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/15360288.2017.1416440 · Cited by 18

Commonly Initiated Opioids and Risk of Fracture Hospitalizations in United States Nursing Homes

Hunnicutt, J. N., Hume, A. L., Liu, S., Ulbricht, C. M., Tjia, J., & Lapane, K. L. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0583-x · Cited by 18

Serotonin syndrome from sertraline monotherapy

Duignan, K. M., Quinn, A. M., & Matson, A. M. (2019) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2019.158487 · Cited by 18

Morphological landscape of endothelial cell networks reveals a functional role of glutamate receptors in angiogenesis

Sailem, H., & Zen, A. A. H. (2020) · Scientific Reports · doi:10.1038/s41598-020-70440-0 · Cited by 22

Fatal serotonin toxicity caused by moclobemide and fluoxetine overdose.

Wu, M.-L., & Deng, J. (2011) · PubMed · Cited by 18

Commonly used gastrointestinal drugs.

Aggarwal, A., & Bhatt, M. (2014) · Handbook of Clinical Neurology · doi:10.1016/b978-0-7020-4087-0.00043-7 · Cited by 17

Diphenhydramine overdose mimicking serotonin syndrome

Tanaka, T., Takasu, A., Yoshino, A., Terazumi, K., Ide, M., Nomura, S., & Sakamoto, T. (2011) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2011.02234.x · Cited by 18

The role of toxicology interpretations in prevention of sudden death

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Exacerbation of Myoclonus by Memantine in a Patient With Alzheimer Disease

Papageorgiou, S. G., Kontaxis, T., Antelli, A., & Kalfakis, N. (2007) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000264995.31771.05 · Cited by 18

Synergistic Regulation of Glutamatergic Transmission by Serotonin and Norepinephrine Reuptake Inhibitors in Prefrontal Cortical Neurons

Yuen, E. Y., Qin, L., Wei, J., Liu, W., Liu, A., & Yan, Z. (2014) · Journal of Biological Chemistry · doi:10.1074/jbc.m114.567610 · Cited by 18

Serotonin Syndrome After Electroconvulsive Therapy in a Patient on Trazodone, Bupropion, and Quetiapine

Cheng, Y., Liang, C.-M., & Liu, H. (2015) · Clinical Neuropharmacology · doi:10.1097/wnf.0000000000000076 · Cited by 18

Involvement of 5‐HT2A Receptors in the Serotonin (5‐HT) Syndrome caused by Excessive 5‐HT Efflux in Rat Brain

Krishnamoorthy, S., Ma, Z., Zhang, G., Wei, J., Auerbach, S. B., & Tao, R. (2010) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/j.1742-7843.2010.00586.x · Cited by 18

Brain pathology in fatal serotonin syndrome: Presentation of two cases

Slettedal, J. K., Nilssen, D. O. V., Magelssen, M., Løberg, E. M., & Mæhlen, J. (2010) · Neuropathology · doi:10.1111/j.1440-1789.2010.01153.x · Cited by 18

Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report

Grenha, J., Garrido, A., Brito, H., Oliveira, M. J., & Santos, F. (2013) · Case Reports in Pediatrics · doi:10.1155/2013/897902 · Cited by 18

Effect of co-administration of varenicline and antidepressants on extracellular monoamine concentrations in rat prefrontal cortex

Rollema, H., Wilson, G. G., Lee, T. C., Folgering, J. H. A., & Flik, G. (2010) · Neurochemistry International · doi:10.1016/j.neuint.2010.10.015 · Cited by 17

Real World Clinical Effectiveness and Safety of Ozanimod in the Treatment of Ulcerative Colitis: 1-Year Follow-Up from a Tertiary Center

Cohen, N. A., Choi, D., Garcia, N. M., Choi, N. K., Picker, E. A., Cleveland, N. K., Cohen, R. D., Dalal, S. R., Pekow, J. R., & Rubin, D. T. (2023) · Digestive Diseases and Sciences · doi:10.1007/s10620-023-08178-8 · Cited by 19

From Evidence to Practice: A Comprehensive Analysis of Side Effects in Synthetic Anti-Depressant Therapy

Pannu, A. S., & Goyal, R. K. (2024) · Current Drug Safety · doi:10.2174/0115748863301630240417071353 · Cited by 21

Rare Case of Serotonin Syndrome With Therapeutic Doses of Paroxetine

Paruchuri, P., Godkar, D., Anandacoomarswamy, D., Sheth, K. N., & NIRANJAN, S. (2006) · American Journal of Therapeutics · doi:10.1097/01.mjt.0000245221.36160.5c · Cited by 17

Selective serotonin reuptake inhibitors and pregnancy: A review of maternal, fetal and neonatal risks and benefits

Marchocki, Z., Russell, N. E., & O’Donoghue, K. (2013) · Obstetric Medicine · doi:10.1177/1753495x13495194 · Cited by 17

A probable case of syndrome of inappropriate antidiuretic hormone secretion associated with linezolid

Baik, S. H., Choi, Y. K., Kim, H. S., Yoon, Y. K., Sohn, J. W., & Kim, M. J. (2015) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp150208 · Cited by 17

Metabolome analysis of the serotonin syndrome rat model: Abnormal muscular contraction is related to metabolic alterations and hyper-thermogenesis

Zaitsu, K., Noda, S., Iguchi, A., Hayashi, Y., Ohara, T., Kimura, Y., Koketsu, Y., Kosaki, T., Kusano, M., Sato, T., et al. (2018) · Life Sciences · doi:10.1016/j.lfs.2018.06.031 · Cited by 17

Fatal overdose with a combination of SNRIs venlafaxine and duloxetine

Alibegović, A., Kariž, S., & Volavšek, M. (2019) · Forensic Science Medicine and Pathology · doi:10.1007/s12024-019-00097-3 · Cited by 17

Serotonin Syndrome in a Patient with Chronic Pain Polypharmacy: Table 1

Lamberg, J. J., & Gordin, V. (2012) · Pain Medicine · doi:10.1111/j.1526-4637.2012.01468.x · Cited by 17

Neurotoxic Emergencies

Barry, J. D., & Wills, B. K. (2011) · Neurologic Clinics · doi:10.1016/j.ncl.2011.05.006 · Cited by 17

Safety Profile of Treatment in Diabetic Peripheral Neuropathic Pain: Table 1

Robinson‐Papp, J., & Simpson, D. M. (2007) · Pain Medicine · doi:10.1111/j.1526-4637.2007.00351.x · Cited by 17

“Robo-Tripping”: Dextromethorphan Abuse and its Anesthetic Implications

Linn, K. A., Long, M. T., & Pagel, P. S. (2014) · Anesthesiology and Pain Medicine · doi:10.5812/aapm.20990 · Cited by 17

Kreislaufstillstand unter besonderen Umständen

Soar, J., Deakin, C. D., Nolan, J. P., Abbas, G., Alfonzo, A. V. M., Handley, A. J., Lockey, D., Perkins, G. D., Thies, K., Böttiger, B. W., et al. (2006) · Notfall + Rettungsmedizin · doi:10.1007/s10049-006-0798-y · Cited by 17

The Gut-Brain Axis in Alzheimer’s Disease: Exploring Microbial Influences and Therapeutic Strategies

Mustafa, M. A., Vadia, N., Varma, P., Al‐Shaker, H., Mohanty, B., Dhyani, A., Kaur, I., Chauhan, A. S., & Garg, G. (2025) · Molecular Neurobiology · doi:10.1007/s12035-025-05474-4 · Cited by 18

Effects of fentanyl on serotonin syndrome-like behaviors in rats

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Serotonin Syndrome Associated with Metaxalone Overdose

Bosak, A. R., & Skolnik, A. B. (2014) · Journal of Medical Toxicology · doi:10.1007/s13181-014-0404-5 · Cited by 16

Therapeutic efficacy and effect on gametocyte carriage of an artemisinin and a non-based combination treatment in children with uncomplicated P. falciparum malaria, living in an area with high-level chloroquine resistance

Okafor, H. U., Shu, E. N., & Oguonu, T. A. (2010) · Journal of Tropical Pediatrics · doi:10.1093/tropej/fmq004 · Cited by 16

Elucidating the Mechanism of Action and Potential Interactions of MAO-B Inhibitors

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The psychoactive drug 25B-NBOMe recapitulates rhabdomyolysis in zebrafish larvae

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Selective serotonin reuptake inhibitors affect structure, function and metabolism of skeletal muscle: A systematic review

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