What is Serotonin syndrome ?


What is Serotonin syndrome ?

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It is quite simply what it sounds like, the symptoms that occur when you have too much serotonin in your body – naturally, functional humans tend to have their levels of serotonin carefully regulated by the brain. Whilst our body is use to having serotonin in it, too much of the chemical can actually have adverse side effects.

In serotonin in particular, it messes with how our nerves interact with our body. Symptoms tend to include everything from diarrhoea, dizziness and vomiting to more severe side effects such as muscle spasms, seizures and loss of consciousness.

How does it occur?
Usually you are taking medication which gives serotonin to your body, most of the time because you are lacking it (according usually to your own admission). As a result your body over the coming days begins to slowly overdose more and more until your side effects become noticeable. The cure in this situation would be to change your medication to suit your problem.

In more rare cases, people can be failing to regulate their levels of serotonin in their bodies – this is obviously not their fault. As such serotonin blockers are usually prescribed.

In most things in the body, too much or too little of a substance is bad. We need it within a specific amount at specific times.

For example, adrenaline. We always have low levels of adrenaline in our body, that is normal. But at times we need high levels (think when you need to run quickly). The body responds by increasing the amount of adrenaline it puts into the blood so it can do its thing. Once we no longer need that high level, the body reduces the amount it puts in the blood again. This is all done by various feed back loops.

Another is insulin. We need more of this when sugar levels in the blood increase, but if insulin levels didn’t fall down again once our sugar levels have fallen back to normal levels, we would get profoundly low blood sugar levels which is dangerous and ultimately lethal.

Now serotonin syndrome:

This is when your body is literally producing too much serotonin. And it is producing phenomenally high amounts. It is usually cause by various drugs. Either an overdose, or an unexpected reaction to normal amounts.

Because of the high serotonin, the serotonin produces the symptoms of serotonin in hyperdrive. These include things like high blood pressure, excessive sweating, really high fever, tremour, agitation, confusion, and other issues.

These symptoms are because serotonin is involved in lots of processes normally, but now that there is too much serotonin, they are all exaggerated.

To treat serotonin syndrome:
1. Stop the drug that caused it in the first place. This will allow the serotonin levels to fall to normal as the serotonin is used up, but not replaced at high levels again
2. Help the patient through the symptoms while the serotonin levels fall. In mild cases it might just be a case of the patient riding it out. In severe cases it might need drugs to counter act the effects of the serotonin while it’s high, and other methods to stop the symptoms that are causing problems, and it may need to be aggressive treatment to save the persons life

This could be things like reducing temperature (really high temperatures over 41C are dangerous and stop vital processes in cells happening). Or paralysing the patient to stop the muscular continually contracting (think major tremour all over the body). This is because that level of sustained muscle contraction will lead to muscle cells breaking down, and the stuff that goes into the blood stream can have effects that causes life threatening arrhythmias, or damage the kidneys.

Once the serotonin levels fall, the supportive treatment can be withdrawn.

And never give the offending drugs again