Drug Interactions

Serotonin Syndrome

TRSerotonin Sendromu
Also known as:Serotonin toxicity · Serotonergic syndrome

A potentially life-threatening drug-induced toxidrome caused by excess serotonergic activity in the central and peripheral nervous systems, typically after combining serotonergic drugs or after overdose.

In depth

The classic triad is altered mental status (agitation, confusion), autonomic hyperactivity (tachycardia, hyperthermia, diaphoresis, mydriasis, diarrhea) and neuromuscular abnormalities (tremor, hyperreflexia, inducible or spontaneous clonus, ocular clonus), usually developing within hours of a drug change. The Hunter criteria, centered on clonus and hyperreflexia after exposure to a serotonergic agent, are the most widely used diagnostic rule.

High-risk combinations involve MAO inhibitors (including linezolid and methylene blue) with SSRIs, SNRIs, tramadol, pethidine, dextromethorphan or fentanyl. Management is withdrawal of the causative drugs, supportive care, benzodiazepines, cyproheptadine in moderate cases, and aggressive cooling with paralysis for severe hyperthermia.

Clinical pearl

Unlike neuroleptic malignant syndrome (onset over days, lead-pipe rigidity, bradyreflexia), serotonin syndrome develops within hours with clonus and hyperreflexia; at least 5 weeks should elapse after stopping fluoxetine before an MAO inhibitor is started.

Example drugs

Linezolid Tramadol Fluoxetine Phenelzine methylthioninium chloride Dextromethorphan
TRIn Turkish

Serotonin Sendromu

Merkezi ve periferik sinir sisteminde aşırı serotonerjik aktiviteye bağlı olarak, tipik olarak serotonerjik ilaçların birlikte kullanımı veya doz aşımı sonrasında gelişen, hayatı tehdit edebilen ilaca bağlı bir toksidromdur.

Klasik triad mental durum değişikliği (ajitasyon, konfüzyon), otonom hiperaktivite (taşikardi, hipertermi, terleme, midriyazis, ishal) ve nöromüsküler anormalliklerdir (tremor, hiperrefleksi, uyarılabilir veya spontan klonus, oküler klonus); tablo genellikle ilaç değişikliğinden sonraki saatler içinde gelişir. Serotonerjik ajana maruziyet sonrasında klonus ve hiperrefleksiyi temel alan Hunter ölçütleri en yaygın kullanılan tanı kuralıdır.

Yüksek riskli kombinasyonlar, MAO inhibitörlerinin (linezolid ve metilen mavisi dâhil) SSRI'lar, SNRI'lar, tramadol, petidin, dekstrometorfan veya fentanil ile birlikte kullanımıdır. Tedavi, sorumlu ilaçların kesilmesi, destek tedavisi, benzodiazepinler, orta şiddetli olgularda siproheptadin ve ağır hipertermide agresif soğutma ile paralizi uygulanmasından oluşur.

Nöroleptik malign sendromdan (günler içinde başlangıç, kurşun boru rijiditesi, hiporefleksi) farklı olarak serotonin sendromu saatler içinde klonus ve hiperrefleksiyle ortaya çıkar; fluoksetin kesildikten sonra MAO inhibitörüne başlamadan önce en az 5 hafta geçmelidir.

Diğer adları:Serotonin toksisitesi · Serotonerjik sendrom
Updated 24.09.2026 1 views Educational reference — verify against current sources before clinical use.

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