Serotonin Syndrome
As people trudge through the winter months and await the spring and summer seasons, their serotonin levels may be dwindling. They may be waiting on longer and brighter days to restore their proper hormonal balance. Fortunately, science has proven that light exposure, exercise, and psychotherapy medications are valid ways to increase serotonin levels within the body. These are viable options for any individual with low serotonin levels hoping to improve the quality of their body’s mood stabilization and overall well being. But how much of an increase is too much?
Much of the conversation around the hormone serotonin is centered upon its depletion associated with clinical diagnoses of depression, anxiety, and insomnia. On the opposite end of the spectrum, however, individuals who experience surges in serotonin levels may experience serotonin syndrome, marked by excessive nerve cell activity. The symptoms of mild serotonin syndrome may manifest as agitation, restlessness, confusion, rapid heart rate, high blood pressure, dilated pupils, loss of muscle coordination, twitching muscles, muscle rigidity, heavy sweating, diarrhea, headache, shivering, or goosebumps. In its most life-threatening form, serotonin syndrome may cause high fever, seizures, irregular heartbeat, or unconsciousness.
These symptoms can be explained by the variety of functions that the hormone serotonin is involved with in the body. Serotonin in the brain regulates mood, happiness, and anxiety, while also connecting with serotonin receptors in certain areas of the brain to control sleeping and waking. Serotonin in the stomach helps control bowel movements and functions. Additionally, serotonin forms blood clots by prompting the narrowing of tiny arteries when the flesh is wounded.
In an almost ironic fashion, individuals with clinically low serotonin levels are most at risk for developing serotonin syndrome because of the medications they are routinely prescribed. Risk is increased for people who are newly taking medications known to increase serotonin levels, newly increasing their dosage of medication known to increase serotonin levels, taking more than one medication known to increase serotonin levels, and taking herbal supplements or illicit drugs known to increase serotonin levels. Antidepressants can potentially cause serotonin syndrome. Additionally, anti-migraine medications, pain medications, illicit drugs, herbal supplements, over-the-counter cough and cold medications and anti-nausea medications offer the same slew of risks. More specifically, the mood stabilizer Lithium, the antibiotic Linezolid, and the anti-retroviral medication Ritonavir used to treat HIV are all medications that have been isolated for their risk.
A doctor would be able to diagnose a case of serotonin syndrome by assessing an individual’s symptoms and ruling out any other possible conditions since there is no singular test to confirm a case of serotonin syndrome. The doctor would need both comprehensive lists of the symptoms an individual is experiencing and the medications he or she is using in addition to knowledge of the individual’s medical history to conduct a physical examination and move forward with a diagnosis. To check for serotonin syndrome, the doctor would measure the levels of any drugs or medications the individual is taking, check for signs of infection, and check body functions that may be affected by serotonin syndrome. To rule out other potential causes of symptoms, a doctor may utilize blood and urine tests, a chest X-rays, a CT scan, or a spinal tap.
Following a diagnosis, and depending upon the severity of the diagnosis, there are a few separate routes of treatment. For a milder case, restoring the normal range for serotonin levels in the blood (101-283 nanograms per milliliter), may simply require stopping taking the medication or medications believed to have caused the surge in an individual's serotonin levels or introducing serotonin-production blocking agents to the individual's bloodstream. The timeframe for recovery is dependent upon the type of medication that caused the surge. Typically, antidepressants tend to remain in an individual's system longest, thereby delaying a complete recovery to a few weeks. More severe cases may require intensive treatment at a hospital where the staff may treat an individual with muscle relaxants, oxygen and IV fluids, drugs to control heart rate and blood pressure, a breathing tube, and medication to paralyze muscles. This is a potentially dangerous condition and it is important to know the risks, symptoms, and treatment options.
References:
https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077351/
https://www.healthline.com/health/mental-health/serotonin#takeaway