Serotonin syndrome - Gynecology

What is Serotonin Syndrome?

Serotonin Syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the central nervous system. It is often a result of drug interactions or overdose of serotonergic agents.

What Causes Serotonin Syndrome?

In the context of Gynecology, serotonin syndrome can be triggered by medications commonly prescribed for postpartum depression, premenstrual dysphoric disorder (PMDD), and chronic pelvic pain. These medications include SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors).

What are the Symptoms?

Symptoms of serotonin syndrome can range from mild to severe and may include agitation, confusion, rapid heart rate, dilated pupils, loss of muscle coordination, or muscle rigidity. Severe cases can lead to high fever, seizures, and unconsciousness.

How is it Diagnosed?

Diagnosis is primarily clinical. A detailed patient history focusing on recent medication changes or additions is crucial. The Hunter Criteria is often used to diagnose serotonin syndrome, which considers the presence of specific signs such as tremor and hyperreflexia.

What is the Treatment?

Immediate discontinuation of the offending agent is the first step. Supportive care, including hydration and cooling, is essential. In severe cases, medications like benzodiazepines may be used to control agitation and seizures, and cyproheptadine can be given as an antidote.

How Can It Be Prevented?

Prevention involves careful medication management. Physicians should start with the lowest effective dose of serotonergic agents and monitor for signs of serotonin syndrome, especially when combining medications. Patient education about the symptoms is also crucial.

Why is Awareness Important in Gynecology?

Awareness is vital because women in the reproductive age group are often prescribed serotonergic medications for various gynecological conditions. Timely recognition and management can prevent serious complications.

Relevant Publications

Neuroanatomical dimensions in medication-free individuals with major depressive disorder and treatment response to SSRI antidepressant medications or placebo.

Issue Release: 2024

Serotonin Syndrome-Mimicking Manifestations in a Patient with Systemic Lupus Erythematosus.

Issue Release: 2024

Visual hallucinations originating in the retinofugal pathway under clinical and psychedelic conditions.

Issue Release: 2024

A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome.

Issue Release: 2024

Ocular Surface Health in Connection with Anxiety and Depression: a Review.

Issue Release: 2024

Delayed Serotonin Syndrome and Non-cardiogenic Pulmonary Edema Following Bupropion Overdose in a Seven-Year-Old Female: A Case Report and Review of Literature.

Issue Release: 2024

Management of Premenstrual Dysphoric Disorder: A Scoping Review.

Issue Release: 2024

Analysis of Natural Antibodies during the Development of Phantom Pain Syndrome.

Issue Release: 2024

Nanovesicular Mediation of the Gut-Brain Axis by Probiotics: Insights into Irritable Bowel Syndrome.

Issue Release: 2024

Off-label higher doses of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: Safety and tolerability.

Issue Release: 2024

Post-marketing safety concerns with lumateperone: a pharmacovigilance analysis based on the FDA adverse event reporting system (FAERS) database.

Issue Release: 2024

Natural products derived from herbs as promising source for diarrhea predominant-irritable bowel syndrome via gut microbiota-serotonin pathway.

Issue Release: 2024

Central 5-HTergic hyperactivity induces myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-like pathophysiology.

Issue Release: 2024

The potential role of the orexin system in premenstrual syndrome.

Issue Release: 2024

Revisiting the Role of Serotonin in Sleep-Disordered Breathing.

Issue Release: 2024

Plasma tryptophan pathway metabolites quantified by liquid chromatography-tandem mass spectrometry as biomarkers in neuroendocrine tumor patients.

Issue Release: 2024

Effect of Vortioxetine in Comparison to Fluoxetine on Metabolic Parameters in Patients With Depressive Disorder: A Randomized Controlled Trial.

Issue Release: 2024

Transient Fever Response After ECT in a Patient with Catatonic Schizophrenia: A Case Report.

Issue Release: 2024

Long-COVID-19 autonomic dysfunction: an integrated view in the framework of inflammaging.

Issue Release: 2024

Biochemical Abnormalities Associated With Sudden Infant Death Syndrome: A Case Report.

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