It’s no secret that substance abuse can affect the chemical levels in your brain. Most addictive drugs target neurotransmitters or chemicals like dopamine, norepinephrine, and serotonin to produce a pleasurable high. Each of these chemicals is associated with mood as well as overall mental well-being. When there’s an imbalance, things can start to go wrong. Our Massachusetts treatment center shares what you should know about serotonin syndrome.
What Is Serotonin Syndrome?
Serotonin syndrome occurs when you take medications that increase the levels of serotonin in your brain and body. Serotonin is a chemical messenger that nerve cells produce. It’s used to send signals between nerve cells and is mostly found in the digestive system, as well as in blood platelets and throughout the central nervous system (CNS). Serotonin is made from tryptophan, which is an amino acid that you get from foods like nuts, cheese, and red meat. Tryptophan deficiency or low levels of tryptophan can contribute to mood disorders like anxiety and depression.
From your emotions to motor skills, serotonin plays various roles in the body. Generally, it’s considered a mood stabilizer and is the main chemical that contributes to sleeping, eating, and digesting. Some other functions of serotonin include:
- Reducing depression and anxiety: In the brain, serotonin regulates anxiety, happiness, and mood. Low levels of serotonin have been linked to depression, while increased levels are thought to decrease arousal.
- Healing wounds through blood clotting: Blood platelets release serotonin to promote clotting and heal wounds. Serotonin does this by narrowing tiny arteries, helping the blood form clots.
- Promoting healthy digestion: Serotonin is primarily found in your digestive system, helping to control your bowel movements and function.
- Stimulating nausea and/or vomiting: This chemical may also produce the sensation of nausea to help put out toxic or upsetting foods more quickly than regular bowel movements or diarrhea. It also increases in the blood, stimulating the area of the brain that controls nausea.
- Maintaining bone health: High levels of serotonin are associated with osteoporosis, a condition that makes the bones weaker and more prone to fracturing and breaking. Maintaining healthy levels of serotonin is imperative for bone health.
- Regulating sexual function and arousal: Low levels of serotonin are associated with increased libido or sex drive, while high levels are linked to reduced libido.
Drugs That Cause Serotonin Syndrome
The basic cause of serotonin syndrome is the excessive accumulation of serotonin. However, this can be exacerbated by taking drugs that impact serotonin levels. While the condition can occur in anyone, those who take antidepressants and other similar substances are more susceptible to serotonin syndrome. Additionally, while serotonin syndrome can result from taking one drug that increases serotonin levels, these conditions occur most often when medications are combined. For instance, taking an antidepressant and a migraine medication together can cause serotonin syndrome.
Several over-the-counter and prescription medications are associated with serotonin syndrome. Illicit substances may also cause this condition. Below is a list of drugs that cause serotonin syndrome:1
- Selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine, paroxetine (Paxil, Pexeva, Brisdelle), and sertraline (Zoloft)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta, Drizalma Sprinkle) and venlafaxine (Effexor XR)
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan) and phenelzine (Nardil)
- Tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor)
- Bupropion (Zyban, Wellbutrin SR, Wellbutrin XL)
- Anti-migraine medications, such as carbamazepine (Tegretol, Carbatrol, others), valproic acid (Depakene), and triptans, which include almotriptan, naratriptan (Amerge), and sumatriptan (Imitrex, Tosymra, others)
- Pain medications, including codeine, fentanyl (Duragesic, Abstral, others), hydrocodone (Hysingla ER, Zohydro ER), meperidine (Demerol), oxycodone (Oxycontin, Roxicodone, others), and tramadol (Ultram, ConZip)
- Illicit drugs, like LSD, ecstasy, cocaine, and amphetamines
- Lithium (Lithobid)
- Herbal supplements, including St. John’s wort, ginseng, and nutmeg
- Over-the-counter cough and cold medications that contain dextromethorphan (Delsym)
- Anti-nausea medications, such as granisetron (Sancuso, Sustol), metoclopramide (Reglan), droperidol (Inapsine), and ondansetron (Zofran, Zuplenz)
- Linezolid (Zyvox)
- Ritonavir (Norvir)
The use of illicit drugs like heroin, methamphetamine, and cocaine can not only cause serotonin syndrome but can also increase your risk of contracting viruses like hepatitis and HIV, affect cardiovascular health, and cause addiction. If you’re addicted to drugs, Clearbrook Treatment Centers Massachusetts offers medical detox and other recovery resources that can aid your recovery.
How Do You Know If You Have Serotonin Syndrome?
In addition to the impact of drug use on serotonin levels, there are also certain risk factors of serotonin syndrome you should be aware of. While this condition can happen to anyone, you’re more at risk of developing serotonin syndrome if you:
- Have recently started taking or increased the dose of a medication that increases serotonin
- Take more than one drug that increases serotonin levels
- Take herbal supplements that increase serotonin levels
- Use illicit or illegal drugs that increase serotonin levels
Serotonin symptoms begin as quickly as 6 hours after taking a new drug or increasing the dose of a drug you’ve been taking, and most people experience symptoms within 24 hours. The first signs of serotonin syndrome include:
- Agitation or restlessness
- Rapid heart rate
- High blood pressure
- Dilated pupils
- Loss of coordination
- Muscle twitching
- Excessive sweating
- Hyperthermia (high body temperature)
Some more life-threatening symptoms of serotonin syndrome include high fever, seizures, irregular heartbeat, and loss of consciousness. If you suspect that someone has this condition after starting a new drug, increasing the dose of their medication, or as a result of drug addiction, get medical assistance immediately. If the individual struggles with a drug problem, then our inpatient rehab in Massachusetts can help.
How Long Does Serotonin Syndrome Last?
Mild versions of serotonin syndrome may last anywhere between 24 and 72 hours after stopping the medication or medications that increase your serotonin levels. Healthcare professionals may also administer certain medications that block the effects of serotonin that are already in your system. However, more severe cases may take several weeks to fully go away. Antidepressants are usually the most common cause of serotonin syndrome and can take longer for the body to eliminate than other serotonin-increasing medications and supplements. The length of time that these drugs stay in your system can also determine the duration of symptoms.
In addition to increasing the dose of a medication or switching medications altogether, illicit drug use can also increase your risk of serotonin syndrome. Drugs like cocaine, heroin, and methamphetamine can create a chemical imbalance in the brain, affecting key neurotransmitters like serotonin. Unfortunately, the impact of drugs on these chemicals is what produces a pleasurable high, which encourages continued drug use.
- NCBI – Serotonin Syndrome