The DOI matches its Crossref record.
The serotonin syndrome
Abstract
OBJECTIVE AND METHOD: A review of the literature on the serotonin syndrome in animals and human beings was conducted, and 12 reports of 38 cases in human patients were then analyzed to determine the most frequently reported clinical features and drug interactions, as well as the incidence, treatment, and outcome of this syndrome. FINDINGS: The serotonin syndrome is most commonly the result of the interaction between serotonergic agents and monoamine oxidase inhibitors. The most frequent clinical features are changes in mental status, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, and tremor. The presumed pathophysiological mechanism involves brainstem and spinal cord activation of the 1A form of serotonin (5-hydroxytryptamine, or 5-HT) receptor. The incidence of the syndrome is not known. Both sexes have been affected, and patients' ages have ranged from 20 to 68 years. Discontinuation of the suspected serotonergic agent and institution of supportive measures are the primary treatment, although 5-HT receptor antagonists may also play a role. Once treatment is instituted, the syndrome typically resolves within 24 hours, but confusion can last for days, and death has been reported. CONCLUSIONS: The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment. Further work is needed to establish the diagnostic criteria, incidence, and predisposing factors, to identify the role of 5-HT antagonists in treatment, and to differentiate the syndrome from neuroleptic malignant syndrome.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cited by
Boyer, E. W., & Shannon, M. (2005) · New England Journal of Medicine · doi:10.1056/nejmra041867 · Cited by 1,821
Treatment-resistant depression: therapeutic trends, challenges, and future directions
Al-harbi (2012) · Patient Preference and Adherence · doi:10.2147/ppa.s29716 · Cited by 796
Neuropathogenesis of Delirium: Review of Current Etiologic Theories and Common Pathways
Maldonado, J. R. (2013) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2013.09.005 · Cited by 745
Bauer, M., Pfennig, A., Severus, E., Whybrow, P. C., Angst, J., Möller, H.-J., & Šon behalf of the Task Force on Unipolar Depressive Disorders (2013) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2013.804195 · Cited by 632
Role of selective serotonin reuptake inhibitors in psychiatric disorders: a comprehensive review
Vaswani, M., Linda, F. K., & Ramesh, S. (2003) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/s0278-5846(02)00338-x · Cited by 612
Lattimore, K. A., Donn, S. M., Kaciroti, N., Kemper, A. R., Neal, C. R., & Vazquez, D. M. (2005) · Journal of Perinatology · doi:10.1038/sj.jp.7211352 · Cited by 189
Callaway, J. C., Raymon, L. P., Hearn, W. L., McKenna, D. J., Grob, C. S., Brito, G. S., & Mash, D. C. (1996) · Journal of Analytical Toxicology · doi:10.1093/jat/20.6.492 · Cited by 160
Heredia, D. J., Gershon, M. D., Koh, S. D., Corrigan, R. D., Okamoto, T., & Smith, T. K. (2013) · The Journal of Physiology · doi:10.1113/jphysiol.2013.256230 · Cited by 144
Serotonin toxicity of serotonergic psychedelics
Malcolm, B., & Thomas, K. (2022) · Psychopharmacology · doi:10.1007/s00213-021-05876-x · Cited by 138
The anaesthetist, opioid analgesic drugs, and serotonin toxicity: A mechanistic and clinical review
Baldo, B. A., & Rose, M. A. (2020) · British Journal of Anaesthesia · doi:10.1016/j.bja.2019.08.010 · Cited by 133
Antidépresseurs et tolérance : déterminants et prise en charge des principaux effets indésirables
David, D. J., & Gourion, D. (2016) · L'Encéphale · doi:10.1016/j.encep.2016.05.006 · Cited by 105
Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines
Taylor, R. W., Marwood, L., Oprea, E., DeAngel, V., Mather, S., Valentini, B., Zahn, R., Young, A. H., & Cleare, A. J. (2020) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyaa033 · Cited by 76
Practical guide for prescribing MAOIs: debunking myths and removing barriers
Grady, M. M., & Stahl, S. M. (2012) · CNS Spectrums · doi:10.1017/s109285291200003x · Cited by 51
Qu, Y., Chang, L., Klaff, J., Balbo, A., & Rapoport, S. I. (2003) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300022 · Cited by 46
Withdrawal reactions associated with venlafaxine
Parker, G., & Blennerhassett, J. (1998) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679809062742 · Cited by 45
Role of Alcohol Consumption in Escalation to Violence
MICZEK, K. A., FISH, E. W., De ALMEIDA, R. M. M., FACCIDOMO, S., & DEBOLD, J. F. (2004) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1330.018 · Cited by 45
Prenatal SSRI exposure: Effects on later child development
Hermansen, T. K., & Melinder, A. (2015) · Child Neuropsychology · doi:10.1080/09297049.2014.942727 · Cited by 38
Putative Neuroleptic Malignant Syndrome Associated With Sertraline Withdrawal
Konstantakopoulos, G., Kouzoupis, A. V., Papageorgiou, S. G., & Oulis, P. (2009) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181a39101 · Cited by 11
(1998) · doi:10.1002/(sici)1099-1077(199804)13:3<191::aid-hup972>3.0.co;2-x
Metadata
- Venue
- American Journal of Psychiatry
- Published
- 1991-06
- Volume
- 148
- Issue
- 6
- Pages
- 705-713
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W1515279996
- Cited by
- 1,342
- References
- 0
- FWCI
- 25.04
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
