Serotonin Syndrome

The varying symptoms of Serotonin Syndrome can be difficult to diagnose. Early serotonin syndrome symptoms, including diarrhea, high blood pressure, anxiety and agitation, can be easily confused with less serious conditions. 

A Challenging Diagnosis, but What is Serotonin¹?

Serotonin is a chemical produced by the nerve cells that acts on almost every part of the body. It’s helps with sleeping, eating, digestion, and is considered to be a natural mood stabilizer. It also helps reduce depression and anxiety, heal wounds, stimulate nausea and maintain bone health. When your serotonin levels are normal, you should feel happier, more calm, emotionally stable, less anxious, and more focused. A deficiency of serotonin would make you experience anxiety and/or insomnia. Many people who experience depression, anxiety, or need mood stabilizers take medications that help to increase serotonin levels in the body.

Medications That Increase Your Serotonin Levels

With the proliferation of antidepressant drugs on the market, there is an increasing number of medications that can raise your body’s serotonin levels. But it’s not just antidepressants that can have this impact. Medications that increase serotonin levels in the body include:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Antidepressants such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil) and sertraline (Zoloft)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): Antidepressants such as trazodone, duloxetine (Cymbalta) and venlafaxine (Effexor)
• Antidepressant and tobacco-addiction medication: bupropion (Wellbutrin)
• Tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor)
• Monoamine oxidase inhibitors (MAOIs): Antidepressants, such as isocarboxazid (Marplan) and phenelzine (Nardil). These are rarely used due to the side effect profile.
• Anti-migraine medications: Triptans (Axert, Amerge, Imitrex), carbamazepine (Tegretol) and valproic acid (Depakote)
• Other medications such as Lithium (mood stabilizer), nausea medications and some over-the-counter medications.

Too Much of Something is Never Good

If serotonin has so many benefits to the mood and can help everyone in their daily functioning, shouldn’t we all want to take as many serotonin increasing medications as possible? The answer is no. Too much of any chemical compound in our body is never a good thing. Serotonin syndrome occurs when medications cause an accumulation of a high level of serotonin in the body. Symptoms of too much serotonin in the body can range from mild to severe, and severe serotonin syndrome can be fatal if not treated¹.

What are the Symptoms of Serotonin Syndrome?

There are no tests to diagnose serotonin syndrome¹. Instead, your doctor might perform a physical exam and ask you some questions to diagnose serotonin syndrome. Due to the lack of diagnostic criteria, the exact prevalence of serotonin syndrome is unknown, however, it is known to be an extremely rare condition. So if you are experiencing any of the symptoms listed below, it’s important that you don’t stop taking any of your medications, but rather, make an appointment to see your doctor to rule out serotonin syndrome.

Mild symptoms of serotonin syndrome may include:

• Agitation or restlessness
• Confusion
• Rapid heart rate
• High blood pressure
• Dilated pupils
• Loss of muscle coordination or twitching muscles
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goosebumps

More severe symptoms of serotonin syndrome may include:

• High fever
• Seizures
• Irregular heartbeat
• Loss of consciousness

Prevention is Key

Taking more than one drug that increases serotonin levels, or increasing the dose of one of these medications, can increase the risk of serotonin syndrome. Make sure your doctor is aware of all the medications you are taking, and discuss any risks and concerns with your doctor or pharmacist to make sure you understand how the medications can interact.

How Can You Naturally Increase Your Serotonin Levels?

Since serotonin offers so many benefits to your mood and health, you may want to consider ways to naturally increase your serotonin levels. Some ways to stimulate natural production of serotonin include:

• Exposure to light: sunshine or bright light to treat seasonal depression can raise your serotonin levels.
• Exercise: getting regular exercise can help to elevate your mood and offers other health benefits!
• A healthy diet: including foods that can help to increase serotonin levels, like eggs, cheese, turkey, salmon, nuts, tofu, and pineapple, can elevate your natural serotonin supply.
• Meditation: helps to relieve stress and promotes a positive outlook on life, thereby increasing your serotonin levels.

References:

1. Scaccia A. Serotonin: What You Need to Know. Healthline Newsletter. https://www.healthline.com/health/mental-health/serotonin. Published May 18, 2017. Accessed February 10, 2018.
2. Serotonin syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758. Published January 20, 2017. Accessed February 10, 2018.

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