Serotonin Syndrome
The case study subject is a female patient with a development disability diagnosis and a history of seizures. She resides in an institution for mental diseases and disorders. Her chronological age is not listed nor her mental age. General assumptions can be made about this case study subject that will assist in setting the groundwork for her case. The individual is most likely over the age of 18 and is most likely at a severe or profound diagnosis level. This is assumed as she is not in a home and community based program often utilized by higher functioning individuals to bring the highest level of independence. A severe or profound individual is often unable to accurately relate information as to their current condition, whether or not there is a fundamental change in how there are feeling in regards sudden onset symptoms. The frequency, severity and duration of seizure activity will alter an individual’s ability to communicate.
Defining Serotonin Syndrome
Serotonin is a chemical substance produced by nerve cells. When the body produces too much serotonin, most often from a drug reaction, serotonin syndrome occurs. This condition has the potential of being life threatening (ADAM 2009). Serotonin syndrome is a result of a hyperserotonergic state; it does not occur due to natural processes of the body (Sorenson 2002).
Serotonin syndrome was first diagnosed in 1959 as a patient with tuberculosis was given a monoamine oxidase inhibitor (MAOI) and tryptophan. The symptoms that manifested included unsteady gait, hyperactive reflexes, clonus, dilated pupils, tremors, CNS excitation, incoordination, paresthesias and lightheadedness.
While these symptoms may be obvious as new symptoms manifesting in the patient with tuberculosis, it is not as easily determined in an individual who has a severe or profound developmental disability and suffers from seizure disorders. To determine if this person has or is experiencing lightheadedness would be difficult if not impossible to accomplish.
Causes of Serotonin Syndrome
When two drugs are taken together that has an effect on the body’s level of serotonin often causes too much serotonin to be produced, released or remains in the brain (ADAM 2009). The medications currently being utilized that can cause the syndrome to develop: migraine medications also known as triptans taken along with antidepressants called selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/enepinephrine reuptake inhibitors (SSNRIs) (ADAM 2009). Brand names for SSRI’s included Lexpro, Paxil, Zoloft, Prozac and Celexa. SSNRI brand names include Effexor and Cymbalta. Triptan brand names are Imitrex, Relpax, Amerge, Zomig, Frova, Maxalt and Axert.
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