Serotonin syndrome is a known adverse reaction associated with the use of some medicines or herbal supplements.
The following are examples of medicines and herbal supplements known to increase serotonin levels:
- Selective Serotonin Reuptake Inhibitors (SSRIs) such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline.
- Tricyclic Antidepressants (TCAs) such as amitriptyline, imipramine, clomipramine, nortriptyline.
- Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs) such as venlafaxine, duloxetine.
- Atypical Antidepressants such as mirtazipine.
- Lithium or linezolid
- Monoamine Oxidase Inhibitors (MAOIs) such as moclobemide, phenelzine, tranylcypromine.
- Opioid Analgesics (pain medication) such as pethidine, fentanyl, tramadol.
- Migraine medication such as sumitriptan, rizatriptan, zolmitriptan.
- Nausea medication such as ondansetron, granisetron.
- Cough suppressants such as dextromethorphan.
- Herbal Products such as St John's Wort.
Some people are more sensitive to these medicines and supplements that cause serotonin syndrome than are others, but the condition can occur in anyone.
You are at increased risk of serotonin syndrome if:
- You recently started taking or increased the dose or have taken too much of a medicine known to increase serotonin levels.
- You take more than one medicine known to increase serotonin levels.
- You take herbal supplements known to increase serotonin levels.
- You use an illicit drug known to increase serotonin levels.