Serotonin reuptake inhibitors poisoning, SSRI - Serotonin syndrome

Medium urgency
-Moderately severe
Serotonin reuptake inhibitors are drugs that are typically used as antidepressants. They act by increasing levels of serotonin (neurotransmitter or substance that transmits nerve impulses) in the brain. This potentially life-threatening condition may arise from the use of these medications, inadvertent interactions and intentional overdose. Symptoms include tachycardia and hypertension, hyperthermia (fever), involuntary sudden movements, tremor, dry mouth and sweating. Diagnosis of serotonin syndrome is only made by classical clinical signs in the context of taking the drugs listed. No laboratory test confirms diagnosis. Treatment varies depending on the severity of the disease and includes stopping taking the medication, normalization of vital signs and sedation with benzodiazepines. In severe cases, drugs will be given to counteract the effects of serotonin.
Bibliographic references
  1. Edward W Boyer. Serotonin syndrome (serotonin toxicity). UpToDate. Aug 2016
  2. Boyer EW. The serotonin syndrome. N Engl J Med 2005; 352:1112.
  3. Birmes P. Serotonin syndrome: a brief review. CMAJ 2003; 168:1439.
  4. De Roos FJ. Drug interactions: Combinations that can kill your patients. American College of Emergency Physicians Scientific Assembly lecture, September 26, 2005, Washington Convention Center.
  5. Canan F. Serotonin syndrome with paroxetine overdose: a case report. Prim Care Companion J Clin Psychiatry 2008; 10:165.
  6. Indalecio Morán, Jaume Baldirà, Luís Marruecos, Santiago Nogué. Intoxicación medicamentosa por fármacos antidepresivos. Intoxicación clínica. Capítulo 14. Páginas 182-184. Grupo Difusión. 
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Symptoms

    Vomiting


    Dry mouth


    Pulse oximeter saturation below 80%


    Coma


    Seizures

Pre-hospital care recommendations

Call medical assistance for instructions.