Serotonin Syndrome

Serotonin syndrome is a dangerous condition that is usually caused by an adverse reaction to medication. Numerous drugs are used to treat headaches that can cause serotonin syndrome. So headache sufferers would be wise to learn more about this potentially life-threatening condition.

What Should I Know About Serotonin?

Serotonin is a chemical located in the nervous system that is used to communicate between the brain and various neurons. It is one of the neurotransmitters. It is responsible, in part, for things like pain, sleep, migraines, anxiety, and depression. Medications known as selective serotonin reuptake inhibitors (SSRIs), such as Paxil or Prozac, increase levels of serotonin as a means to treat depression. The “triptans,” used to treat acute migraine headaches, also affect serotonin levels, even leading to serotonin syndrome.

The Syndrome

Serotonin syndrome is a result of increased serotonin activity in the central nervous system (CNS) and at peripheral serotonin receptors. It causes a variety of symptoms that can be categorized as cognitive (affecting the mind), autonomic (affecting the body’s “automatic” processes), or somatic (affecting the musculoskeletal system).

Cognitive effects include:

• mental confusion
• hypomania
• hallucinations
• agitation
• headache
• coma

Autonomic effects include:

• shivering
• sweating
• hyperthermia (increased body temperature)
• hypertension
• tachycardia (rapid heart rate)
• nausea
• diarrhea

Somatic effects may include:

• muscle twitching
• hyperreflexia (increased reflexes)
• tremor

There are also a variety of other problems including metabolic abnormalities, muscle wasting, kidney failure, and abnormalities of blood clotting that can occur as a result of serotonin syndrome. Your health care provider can help make the diagnosis and arrange proper treatment.

What Should I Do?

The first thing to do in the case of serotonin syndrome is to stop taking the medication, if possible. Health care professionals will do their best to control the symptoms with whatever means are necessary, often through medications. Most importantly, let your health care provider know if you are at all worried about developing serotonin syndrome. He or she can help you make appropriate decisions about treatments for your headaches, avoiding potential dangers where they exist.

_Sources:

_{Boyer EW, Shannon M. “The serotonin syndrome.” N Engl J Med. 2005 Mar 17;352(11):1112-20.}

_{”Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome.” FDA Public Health Advisory. Created July 19, 2006. Accessed March 18, 2009.}