Treatment for Serotonin Syndrome

     Serotonin syndrome may occur when there is too much serotonin in the central nervous system. This condition can be caused by a drug interaction, such as when multiple medications that increase serotonin levels are taken together. Serotonin syndrome can be life-threatening. Anxiety, disorientation, sweating, increased heart rate, and increased blood pressure are signs and symptoms of the condition. A tremor or twitching may also develop. Symptoms typically begin within the first day after starting a new medication or increasing the dose of a medication that increases serotonin.

     Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil) and citalopram (Celexa), have the potential to cause serotonin syndrome. Tramadol (Ultram), bupropion (Wellbutrin), and venlafaxine (Effexor) are examples of other medications that increase serotonin levels.  If the condition occurs, these types of medications should be stopped. A benzodiazepine, such as diazepam (Valium), may be given to treat agitation and also small increases in blood pressure and heart rate. If blood pressure and heart rate are severely increased, esmolol (Brevibloc) is a medication for the heart that may be prescribed. If additional treatment is still needed, cyproheptadine is an antidote that may be administered.