THE SEROTONIN SYNDROME - 4 CASE-REPORTS AND A CONCISE REVIEW OF THE LITERATURE

The serotonin syndrome, characterized among others by confusion, restl essness, myoclonus, hyperreflexia, tremor, ataxia and hyperthermia, is a rarely described complication of treatment with serotonin enhancing antidepressants. The differential diagnosis comprises delirious state s and neuroleptic malignant syndrome. The pathogenesis is thought to b e related to activation or changes in the sensitivity of 5-HT1a subrec eptor systems in brain stem and spinal cord or an overall enhancement of 5-HT neurotransmission. Symptomatology and etiological factors are described by reporting four patients. It is concluded that this compli cation may be underreported in view of the increasing use of antidepre ssants with a more or less specific serotoninergic mode of action.