Effect of selective serotonin reuptake inhibitors and Monoamine Oxidase inhibiter in Serotonin syndrome
serotonin (5-hydroxytryptamine, 5-HT) is produced from brainstem raphe nuclei consist of nine nuclei that produce serotonin, forming an inferior caudal group, which sends excitatory axons to the spinal cord and medulla (descending pathways), and a superior rostral group, from which ascending projections (ascending pathways) inhibit thalamic and cortical regions. It has been postulated that ascending pathways are associated with sleep and synchronization of cortical neurons, whereas descending rant nociceptive-type pathways, when stimulated, result in inhibition of neurons in the spinothalamic tract and cause analgesia cant cross the blood-brain barrier, it had many functions in centrally and peripherally neurons in nerve system such as in the peripheral nervous system (PNS) includes vasoconstriction via smooth muscle stimulation, platelet aggregation, uterine contraction, intestinal peristalsis, and bronchoconstriction; and in central nervous system (CNS) has effects on controlled behavior, attention, affect, cardiorespiratory function, pain perception, and aggression.
Other
Serotonin syndrome (SS) is a consequence of the interaction between serotonergic agents and monoamine oxidase inhibitors. The most frequent clinical features are changes in mental status. Its effect in the brainstem and spinal cord on specific type of the serotonin (5-hydroxytryptamine, or 5- HT) receptor. Both sexes have been affected, and patients’ ages have ranged from 20 to 68 years. stoppage of the suspected serotonergic agent and institution of supportive measures are the primary treatment. Once treatment is beginning the syndrome naturally resolves within 24 hours, but confusion can last for days and death in some cases. Conclusions: The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment. Further work is needed to establish the diagnostic criteria, incidence, and predisposing factors, to identify the role of 5-HT antagonists in treatment, and to differentiate the syndrome from the neuroleptic malignant syndrome(1)(2)
