In mild cases dominate gladly muscle hampered phenomena, mainly from the lower limbs. In moderate c

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Serotonin syndrome hampered can be defined as a condition that occurs when serotonin levels in the synapses - the connections between neurons - in the brain becomes too high. This can happen when using drugs that inhibit the reuptake of serotonin from the synapse, drugs that increase the secretion of serotonin from the presynaptic neuron and into the synapse, and drugs that inhibit the enzyme monoamine oxidase (MAO), which breaks down serotonin (1-3) .
Since the levels of serotonin in the synapses must increase significantly, in the order of 10-50 times for the syndrome to occur, it is very unusual to develop a serotonin syndrome when the current drugs used as monotherapy. Not even when consuming funds in overdose, the risk is particularly high. The syndrome is seen in only about 15 percent of all who take selective serotonin reuptake inhibitors (SSRIs) in overdose. In silk cases are not particularly severe symptoms. It is only when you combine two drugs that work by increasing serotonin levels via different mechanisms that risk is high and symp-tomene severe (1-3).
In animal hampered studies have shown that symptoms become hampered more and more pronounced the higher serotonin concentration that exists synapses. There is thus a gradual transition from the common side effects that occur with the use of serotonin stimulant drugs through a mild serotonin syndrome to the more severe forms. Therefore, some prefer to call state of serotonergic toxicity in place of serotonin syndrome (2). It is also shown that it is the degree of stimulation of a particular subtype of serotonin receptors, 5-HT2A receptor, which mediate hampered the symptoms (1).
Since a serotonin syndrome occurs immediately plasma levels of it or the drugs that affect serotonin function has been sufficiently high to provide serotonin Nerg overstimulation, the symptoms usually relatively quickly after starting treatment or increasing the dose. In patients who develop a serotonin syndrome during treatment in monotherapy occurs symp-tomene usually within a few days after initiation or dose increase. By consuming a serotonergic agent in overdose occurs syndrome hampered within hours. When the syndrome is due to a combination of two drugs, occurs in the rule already after taking it or the first doses of the mid panel is added.
The purpose of this paper is to present an overview of the symptoms of serotonin syndrome, which drugs and drug combinations that might trigger such a syndrome, and what treatment is appropriate. Materials and methods
The most common symptoms and clinical discoveries by serotonin syndrome are presented in Table 1. The oldest definition of serotonin syndrome, 1991 (4), demanded that one should hampered have 3-4 of these symptoms, but did not describe in more detail the symp-tomkombinasjoner this would apply. hampered Eventually it turned out that this definition was too unspecific, and it has more and more started to use diagnostic criteria that provide far greater diagnostic accuracy. The most common set of criteria today is "The Hunter Serotonin Toxicity Criteria" (3, 5). According to these criteria are spontaneously arisen clonus (a special type of rhythmic muscle movements) in a patient who has ingested one or more serotonergic hampered drugs sufficient to make the diagnosis. Diagnosis is also true if the patient has very severe hampered muscle reflexes or clonus triggered a refleksham systems, combined with autonomic symptoms (Table 1), agitation or tremor.
In mild cases dominate gladly muscle hampered phenomena, mainly from the lower limbs. In moderate cases was added-more autonomic symptoms such as tachycardia, fever and sweating. hampered At the more severe cases, hampered muscle hampered symptoms stronger hampered and more generalized and the mental symptoms of agitation and restlessness are also more prominent. Clonus of the ankle joint, either spontaneously or triggered by a reflex hammer, is a key phenomenon. Serious, life-threatening cases are characterized by powerful muscle stiffness and involuntary hampered muscle movements, high fever, hyperventilation, confusion and delirium. Complications such as metabolic acidosis, seizures and rhabdomyolysis with renal failure may occur, probably hampered as a consequence of the involuntary muscle movements and high body temperature secondary to this. Triggering agents
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