Many drugs such as antidepressants work by increasing the availability of serotonin within the brain and nervous system. This can become problematic when one or more drugs that cause increases in serotonin are taken together. Excessive increases in serotonin can lead to unwanted adverse reactions such as agitation, tremor, muscle rigidity, hyperthermia, flushed skin and excessive sweating.
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Unless you're a healthcare professional, you probably are not aware of the serotonin syndrome. Pharmacists in particularly familiar with the syndrome and screen patient medication profiles for potential occurences. Serotonin is a naturally occuring substance responsible for signaling between neurons or generating impulses that travel throughout the nervous system. Serotonin is involved in processes such as gastrointestinal motility, uterine contractions, bronchoconstriction and thermoregulation to name a few.
In rare or more severe cases, the syndrome can actually be life-threatening. Drug classes implicated in this syndrome include antidepressants (e.g. fluoxetine, paroxetine, venlafaxine), analgesics (e.g. meperidine, tramadol, fentanyl), lithium, cough preparations containing dextromethorphan (e.g. Benylin DM), and St John's wort. The elderly are particularly more prone to this syndrome if dosages are not adjusted accordingly. Fortunately, the condition and its symptoms are easily managed by discontinuing the involved medications. The syndrome can also be reversed with antidotes (e.g. cyproheptadine).
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