Br J Anaesth 2020 01 22;124(1):44-62. Epub 2019 Oct 22.
Department of Anaesthesia, Royal North Shore Hospital of Sydney, Sydney, NSW, Australia; Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
Most cases of serotonin toxicity are provoked by therapeutic doses of a combination of two or more serotonergic drugs, defined as drugs affecting the serotonin neurotransmitter system. Common serotonergic drugs include many antidepressants, antipsychotics, and opioid analgesics, particularly fentanyl, tramadol, meperidine (pethidine), and methadone, but rarely morphine and other related phenanthrenes. Symptoms of serotonin toxicity are attributable to an effect on monoaminergic transmission caused by an increased synaptic concentration of serotonin. Read More