What is Serotonin syndrome ?
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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
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