Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
14.1 Serotonin toxicity
An overdose of some medications or some medication combinations can cause the build up of too much serotonin in the nervous system and the rest of the body. The syndrome is potentially fatal.
Common features are as follows:
- Severe restlessness.
- Over-excitability and hyperactivity (hypomania).
- Sweating and shivering.
- Diarrhoea.
- Fever
- Lack of coordination.
- Confusion and altered consciousness.
- Tremor.
- Jerking limb movements (termed myoclonus).
The syndrome can be treated with withdrawal of the medications that caused it in the first place. Sedative medications such as diazepam or lorazepam are sometimes needed. If more severe then intensive care is required.
Derived from Isbister, 2007(530).


