Diagnosis

The diagnosis of a serotonin syndrome is made clinically. This means that no special examinations, such as laboratory tests, are necessary to make the diagnosis. The patient’s symptoms alone (see section on accompanying symptoms) and knowledge of his or her medication are sufficient to make a diagnosis of serotonin syndrome, which requires immediate action. There is no specific laboratory test that proves the presence of serotonin syndrome. Malignant neuroleptic syndrome is an important differential diagnosis.

What are the signs of serotonin syndrome?

A serotonin syndrome can manifest itself in many different ways. Many symptoms appear rather unspecific, especially at the beginning of the syndrome. These include fever and flu-like symptoms, which can easily be mistaken for a viral infection.

Nausea, vomiting or diarrhoea are also possible signs of a serotonin syndrome. Sweating can also be a sign of a serotonin syndrome. Psychological abnormalities such as restlessness, anxiety or delusions can also indicate a serotonin syndrome.

As a matter of principle, caution should be exercised especially when increasing the dose of an existing antidepressant medication or when taking additional medication. By paying attention to signs of serotonin syndrome, the risk of overlooking it is minimized. New symptoms that cannot be explained in any other way should, in combination with antidepressant medication, make you more alert.

Associated symptoms

Serotonin syndrome causes a number of different symptoms that can be assigned to different groups. They are all based on the increased serotonin effect. This group includes symptoms like sweating, fever and high blood pressure.

Since they can resemble flu at the beginning, they are easily overlooked. A serotonin syndrome can also lead to symptoms like that which can also feign another illness.

Diarrhea
Vomiting and
Nausea

Some symptoms that are assigned to this group can only be recognized by the doctor.

One of these is the so-called hyperreflexia, which refers to an amplification of the reflexes. It can be discovered during the examination, but is not directly noticeable to the person concerned. Another important symptom is involuntary, short muscle twitches called myoclonies.In addition, tremor and so-called ataxia occur, which is a disorder of coordinated movement.

Ataxia is not always easy for the patient to recognize. In pronounced cases, it manifests itself as a gait disorder and a disorder of eye movements. In many cases, however, only specific examinations can bring ataxia to light.

Psychiatric symptoms: The psyche is also affected by a serotonin syndrome. The symptoms can be very strong, but also very weak. They range from mild agitation to delirium with hallucinations.

Furthermore, anxiety can accompany the symptoms. The restlessness can be increased to such a degree that it is not possible for the affected person to sit still for a minute. The psychological symptoms in particular cause a high degree of suffering for the affected persons.