Abstract:
Serotonin syndrome (SS) is a drug-induced clinical syndrome resulting from increased serotonergic activity in the central nervous system. Although more than seven decades have passed since the first description of SS, it is still an enigma in terms of terminology, clinical features, etiology, pathophysiology, diagnostic criteria, and therapeutic measures. The majority of SS cases have previously been reported by toxicology or psychiatry centers, particularly in people with mental illness. However, serotonergic medications are used for a variety of conditions other than mental illness. Serotonergic properties have been discovered in several new drugs, including over-the-counter medications. These days, cases are reported in non-toxicology centers, such as perioperative settings, neurology clinics, cardiology settings, gynecology settings, and pediatric clinics. Overdoses or poisonings of serotonergic agents constituted the majority of the cases observed in toxicology or psychiatry centers. Overdose or poisoning of serotonergic drugs is uncommon in other clinical settings. Patients may develop SS at therapeutic dosages. Moreover, these patients may continue to use serotonergic medications even if they develop mild to moderate SS due to several reasons. Thus, the clinical presentation (onset, severity, and clinical features) in such instances may not exactly match what toxicologists or psychiatrists observe in their respective settings. They produce considerable diversity in many aspects of SS. However, other experts discount these new developments in SS. Since SS is a potentially lethal illness, consensus is required on several concerns related to SS.
摘要:
5-羟色胺综合征(SS)是由中枢神经系统中5-羟色胺能活性增加引起的药物诱发的临床综合征。尽管自第一次描述SS以来已经过去了70多年,就术语而言,这仍然是一个谜,临床特征,病因学,病理生理学,诊断标准,和治疗措施。大多数SS病例以前是由毒理学或精神病学中心报告的,特别是患有精神疾病的人。然而,血清素能药物用于除精神疾病以外的各种疾病。已经在几种新药中发现了血清素能特性,包括非处方药。这些天,病例在非毒理学中心报告,如围手术期设置,神经科诊所,心脏病学设置,妇科设置,和儿科诊所。在毒理学或精神病学中心观察到的大多数病例是血清素能药物的过量或中毒。5-羟色胺能药物过量或中毒在其他临床环境中并不常见。患者可在治疗剂量下发展SS。此外,这些患者可能会继续使用5-羟色胺能药物,即使他们由于多种原因发展为轻度至中度SS.因此,临床表现(发病,严重程度,和临床特征)在这种情况下,毒理学家或精神科医生在各自的环境中观察到的情况可能不完全匹配。它们在SS的许多方面产生相当大的多样性。然而,其他专家对SS的这些新发展不屑一顾。因为SS是一种潜在的致命疾病,需要就与党卫军有关的几个问题达成共识。