What is Serotonin Syndrome - Is It Fatal?

Serotonin is a brain chemical, also called neurotransmitter that plays a role in controlling your mood and anxiety. Low levels of this in your brain contribute to depression and anxiety. Therefore, many of the medications we use to treat depression and anxiety work by increasing the levels of serotonin in your brain.

Serotonin syndrome happens when you get an excess amount of serotonin from taking super high doses of the medication like if you were to take an overdose or when medications get combined with other medications that increase serotonin.

Serotonin syndrome symptoms can range from mild to severe and fall into three groupings and you should have symptoms in all three categories:
Changes in your mental state
Abnormal muscular tone
Hyperactive autonomic nervous system

Here are the take aways from this video
1. If you are taking antidepressant medications be careful anytime you add another medication even something over the counter. You always want to check the drug-drug interactions. You can use the drug interaction checker on Web MD. This applies to some prescription pain medications like Tramadol and Imitrex for migraines.

2. Normal use of your antidepressant shouldn’t cause this problem, but if you have combined it with something, look out for odd signs like fever, wide open pupils, abnormal blood pressure and muscle stiffness. Those are the symptoms that are not the normal side effects. If you are experiencing these things call your doctor or go the your nearest urgent care or emergency room. To determine if you have serotonin syndrome, someone will need to examine you, monitor your vital signs and observe you. It usually goes away within 24 hours once you stop the medications.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[meganleigh]

I want to thank you, even if you dont see this. Sincerely and whole heartedly. Your channel has changed my outlook in such an intense way. I'm working on going through therapy right now for several mental illnesses. I've always struggled thinking something is wrong with me and not understanding why I feel the way I do. I didn't seek out therapy for my severe suicidal thoughts and mania until watching your videos and realizing that there are other people out there who have gotten through these debilitating feelings. Thank you for this channel, thank you for sharing your knowledge in ways that everyone can understand, and thank you for helping me. 🖤

[nadiarittenberry]

I had Serotonin Syndrome due to a suicide attempt. I was in the ICU for three days with constant seizures. The only thing that helped was Ativan. I regret it and I am glad to still be here

[altheaunertl]

Is that your child? Y'all are so cute together. 😊

[dark_baphomet]

Thank you for clarifying, I’ve found a lot of the symptoms look similar to the side effects on the leaflets and I know it can be fatal so I was quite worried, but now I know the more in depth symptoms serotonin syndrome has and how they differ to regular side effects I know what to look for and when not to worry, so thanks for putting my mind at ease

[QuiltLady]

As a retired RN may I suggest that everyone take their meds or a list of current meds, including over the counter and herbals when going to any doctor. Also make sure each doctor has a list of any other doctors you see, especially the information for your Primary Care doctor. I am older so have a med planner. A small calendar to write down new noted symptoms no matter how small and the days and times the occur is very helpful to your doctor in helping you. Don’t be afraid to use your pharmacist too. Save and read those pages the pharmacist gives out to you with each new medicine. Dr. Marks you are an amazing and kind physician. I am a retired RN but love to still delve into all things medical. Take care of yourself. I also enjoy and learn from everyone’s comments. Thank you.

[nyjahharris]

Im 18 and was sent to the hospital last Sunday due to a mild case of serotonin syndrome. I was taking lexapro but recently increased my dosage to 10mL(I took a liquid form). My serotonin levels decreased within the next 1-2 days but it was the most mentally and physically painful/scary/exhausting experience i've ever had. I am currently recovering and being monitored by my doctor because it messed my body up. I have increased calcium levels and low white blood cell counts and a few other lingering symptoms(this could be from lexapro withdrawl). I am also dealing with withdrawal symptoms from lexapro and I am so mentally exhausted from it all. I never wish this pain on anyone. Thank you so much for posting his video because many people do not know serotonin syndrome exists. You are amazing Dr. Tracey <3

[Storm]

I wish you were my psychiatrist. I'm having such a hard time right now with anxiety and depression, and having a lot of physical symptoms. I'm scared of meds and the first antidepressant I tried gave me tremors. You are so intelligent and comforting.

[valeferht]

The syptoms are very similar to a panic attack, so now i have to tell my health anxiety filled mind that i'm not dying 😅

[margottfon]

Conclusion: if you have a "mild" form of the serotonin syndrome, you're NEVER diagnosed, never die, but spend the whole life in the state of being dead.

[tylerbriggs]

I actually just dealt with/still experiencing serotonin syndrome. The weirdest part is that I only got it from starting one drug with serotonin in it. It didn’t end up being bad but it’s probably the worst drug interaction I’ve had. I’m also going through some Xanax withdrawal symptoms even though I only took less than 0.5 mg.

[Topbrass]

Thank you for sharing. I recently experienced a severe case of seritonin syndrome. I am on several antimigraine medications and antidepressants. I was with a bunch of friends and since it has become legalized in my state, I was offered a puff of marijuana. It wasn't laced at all as everyone else was fine. That little extra just put my body into full seritonin syndrome. Vomiting, convulsions, confusion, profuse sweating were some of my immediate symptoms. I had to go to the hospital and was discharged the next day. It was one of the scariest times in my life

[carrisringcircus]

I was on 2 Antidepressants and Tramadol. I fell out in a Grand mal seizure, my hubby had a hard time getting me to the ER, I was fighting him but I don't remember. After getting to the ER I had more seizures and my heart rate was in the 200s for hours. I was I ICU for 4 days.
They called it Severe Serotonin Syndrome

[yelahm]

What about Dopamine in the brain? Can you do a video about Dopamine problems in the brain?

[topperharley]

Had this after an OD of zoloft 30 pills. Was having hallucinations audio and visual and couldn't feel waist down and could not talk propertly

[emmae]

Your videos helped me review for the LMSW exam and I passed yesterday! Your videos are great for clinicians too!

[GLGC]

This can happen very quickly in people with mast cell disease and dysautonomia. One pill of Zoloft sent me to the ER. Initially I thought it was an allergic reaction, but it happened again with each SSRI I was tried on.
I have a mast cell disease and it makes my body very hyperreactive to medication. In the ER, though, I was treated as a psych patient instead. I would have all the symptoms including the clonus and rigidity and significant confusion and word slurring and they consistently treat me as if it is "panic attacks."

[Kingboo]

I had Serotonin Syndrome about 3 months ago. It was AWFUL. It happened because I tried to OD. I took my regular antidepressant (Fluvoxamine) and a MAOI (an old antidepressant I had left in the cupboard). It was the worst experience I’ve ever had. It’s made me never want to try and OD again. Mine resolved within the 24 hour time frame and they had me take Cyproheptadine for a few days.

[thsis]

So glad that you're shedding light on this. I havent looked, but I would be very interested on your take on how many psychiatric meds have an impact on weight and possibly can lead to cormid diagnosis of diabetes. Diabetes can lead to some serious complications and I feel like this is not properly discussed openly with those who are qualified. While I have made the personal decision to stop medication, as a diabetic I feel it is something that needs to be brought to the public's attention.

[briagolliday]

This video really demonstrates how important it is to tell your health professionals what medications you are currently taking. If anyone is like me, sometimes you don't feel like listing (seemingly unimportant) medication after you've filled out multiple pages of paperwork.
P.S. I love your videos and the VALUE you are providing to the world and people who need it most!! Youtube algorithm brought me to your channel. Not by coincidence. Thank you, sincerely!

[Roxanna.wez]

Thanks to Sage for asking this question and to Dr. Marks for your thorough explanation (as always) 👍