Serotonin syndrome

A serotonin syndrome was first described for an interaction between fluoxetine and an MAOI. This life-threatening syndrome includes severe muscle rigidity, myoclonus, hyperthermia, cardiovascular instability, and marked CNS stimulatory effects, including seizures. Drugs implicated include MAOIs, TCAs st johns wort dextromethorphan, meperidine and possibly illicit recreational drugs such as MDMA (“ecstasy”). Antiseizure drugs, muscle relaxants, and blockers of 5-HT receptors (eg, cyproheptadine) have been used in the management of the syndrome.