Serotonin syndrome how long can it last

You may also need IV fluids for dehydration and fever, or supplemental oxygen. The length of time that you could experience serotonin syndrome varies. If you have a mild form of serotonin syndrome, you may feel better within one to three days.

Some cases can take several weeks to go away, depending on which medication s caused the reaction and how long the medication s stay in your body.

Because of the importance of treating serotonin syndrome early, it is critical to seek immediate treatment if you have symptoms. Anyone who takes medicine that increases serotonin is at risk of serotonin syndrome. Always check with your healthcare provider to make sure that the medications you take are compatible. Skip to main content Search for a topic or drug.

Learn to spot the signs of serotonin syndrome. By Karen Berger, Pharm. Top Reads in Health Education. What is insulin resistance? Do coffee and diabetes mix? Diabetes in women Nov. How to lower blood sugar Nov. Looking for a prescription? Search now! The patient having seizure reported within 24 h. However, all other patients took 4 days-3 weeks before reporting to the physicians. They ignored their symptoms in the early part as these were not interfering with their routine activities.

There is no prospective controlled study regarding the treatment of SS. The treatment strategies are based on case reports and speculated pathophysiology in the generation of SS.

The intensity of treatment depends on the severity of SS. Treatment of severe serotonin toxicity begins with the identifying its presence. Cyproheptadine is the drug of choice for the SS. Other drugs with the property of blockading5-hydroxytryptamine 2A 5-HT2A receptors chlorpromazine and olanzapine may also be used. However, in another seven patients, there were minimal or no response to removal of the drugs.

These patients responded to cyproheptadine. Responses started in days of initiation of cyproheptadine. Patients were asked to continue cyproheptadine for more days after the disappearance of the symptoms. All patients were followed for at least 2 months. None of the patients had similar symptoms in the follow-up.

In parallel to central 5-HT effects, peripheral 5-HT receptors and other neurotransmitters also contribute to the pathophysiology of SS. However, it can occur even after discontinuation of a serotonergic drug and it has been suggested that a suspicion of SS could be done even in patients who had taken such drug in the past 5 weeks.

Intensity of SS is probably related to the extent of increased serotonin. Synergistic effects of two or more serotonergic agents might have more severe symptoms. On many occasions, mechanisms for the generation of SS remain unclear. Various review articles and case series suggest that a large number of symptoms may be present in patients with SS. Diagnosis of severe SS may be straightforward.

However, a diagnosis of mild SS may not be simple as mild serotonin toxicity includes a large number of nonspecific symptoms. Our case series highlight that patients may have a wider range of nonspecific symptoms. Making a diagnosis of such patient may be difficult. Tremor is a well-known recognized symptom of SS. Other patients did not report tremor. It was noted on physical examinations.

Disappearance of tremor on removal of the serotonergic drug and by therapy with cyprohepatadine indirectly suggests that tremor was the part of the SS. The presenting features in another eight patients were: Dizziness, generalized bodily pain, headache, insomnia, and seizure.

Review of the literature suggests that these all symptoms are the part of the spectrum of serotonin toxicity. Diagnosis of SS is clinical one with exclusion of other etiology and diagnosis mainly depends on good physical examinations as diagnosis of SS depends on the demonstration of a few specific physical signs clonus, hyperreflexia, tremor, ocular clonus, hypertonia, etc. Such examinations are often omitted by physicians for such nonspecific symptoms.

Even the side effects profiles of various SSRIs and other serotonergic drugs are silent about the presence or absence of hypereflexia or clonus or hypertonia. A patient with mild SS might continue drug for many months because of the unawareness of SS. The incidences of the SS have been increasing with the increasing use of proserotonergic agents in clinical practice.

Every patient with mild SS is a potential candidate to develop severe SS. Patients may receive a second serotonergic drug inadvertently and patients may land into life-threatening severe SS. Therefore, a diagnosis of mild SS is very important. Diagnosis of SS depends on physical examinations. We suggest that any patient on serotonergic drug, if develops any new symptom, should be examined for the presence of tremor, hypertonia, hyperreflexia, and clonus.

It is a retrospective study and possibilities of unrecognized selection bias and recall bias exist. Temporal relation of onset of clinical features with administration of serotonergic drugs and the presence of various physical signs clonus, hyperreflexia, etc.

In the same way, resolution of symptoms by removal of the offending agents and treatment with cyproheptadine reconfirm the possibility of SS.

However, we cannot rule out a possibility of another cause as full evaluation for secondary cause was not done on each patient. As there is no guideline for the treatment of mild SS, the management protocol was not standardized.

A possibility of placebo response is also there in these patients and spontaneous remission may occur in a few patients. The incidence of SS is increasing with widespread use of proserotonergic agents. But, it is highly under diagnosed condition.

Under diagnosis is more likely with mild SS. Every patient with mild SS is a potential candidate for developing life-threatening, severe SS. There is a need to increase its awareness. It is suggested that every patient on serotonergic drug should be examined for the presence of tremor, hypertonia, hyperreflexia, and clonus. Source of Support: Nil.

Conflict of Interest: None declared. National Center for Biotechnology Information , U. Ann Indian Acad Neurol. Author information Article notes Copyright and License information Disclaimer. For correspondence: Dr. E-mail: ni. Received Sep 16; Accepted Nov However, it does play an important role. Simply put, serotonin syndrome is the result of too much serotonin in the body.

In general, this does not happen naturally. Rather, serotonin toxicity is the result of a medication or a combination of medications that cause a surplus of serotonin. The condition can range from mild to life-threatening and can be challenging to diagnose.

Mild serotonin syndrome especially is a condition that is often overlooked. This is due to the fact that symptoms of mild serotonin syndrome are shared among many other conditions. Further, there is no lab test to confirm the diagnosis of this condition. Rather lab tests are generally used to rule out other medical problems. Unfortunately, mild serotonin toxicity can progress rapidly, especially if the medication causing the problem is not immediately stopped.

For this reason, it is vital to catch symptoms early before a more serious condition develops. The onset of serotonin syndrome can happen quickly.

A person may experience symptoms within a few hours of taking the medication that alters serotonin levels. Mild serotonin syndrome symptoms often includes the following:. Given the prevalence of these symptoms among other diseases and ailments, it is easy to see how the signs of mild serotonin syndrome can be overlooked. If the above symptoms are noted in any individual, it is important to call immediately as serotonin syndrome can be fatal if not treated.

Usually, the doctor will eliminate the presence of other conditions first. Other conditions that can be confused with serotonin syndromes include infections i. Serotonergic agents are substances that alter serotonin levels in the body. Oftentimes, a person is prescribed a serotonergic agent to address a mental illness such as depression. Examples of serotonergic agents include antidepressants such as:. In addition, many prescription drugs and over-the-counter remedies can cause an increase in serotonin levels.

While serotonin syndrome may occur after taking a single medication, this is unlikely. Rather, it is usually the result of a combination of products that increase serotonin or alters serotonin uptake. Alternatively, someone may intentionally or accidentally take too much of the same medication causing a serotonin overdose. Examples of other serotonergic drugs that pose a danger if they are combined serotonin increasing drugs include:.