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Síndrome de la serotonina - Overview

Nombres alternativos

Hiperserotoninemia; Síndrome serotonérgico

Definición:

Es una reacción farmacológica potencialmente mortal que hace que el cuerpo tenga demasiada serotonina, un químico producido por las neuronas.

Causas, incidencia y factores de riesgo:

El síndrome de la serotonina se presenta con más frecuencia cuando se toman juntos y al mismo tiempo dos medicamentos que afectan el nivel de serotonina del cuerpo. Los medicamentos hacen que se libere demasiada serotonina o que demasiada serotonina permanezca en el área del cerebro.

Por ejemplo, uno puede desarrollar este síndrome si toma medicamentos para la migraña, llamados triptanos, junto con antidepresivos, llamados inhibidores selectivos de la recaptación de la serotonina (ISRS) e inhibidores selectivos de la recaptación de la serotonina/norepinefrina (ISRSN). Los ISRS populares abarcan: Celexa, Zoloft, Prozac, Paxil y Lexapro. Los ISRSN abarcan: Cymbalta y Effexor. Las marcas comerciales de los triptanos comprenden: Imitrex, Zomig, Frova, Maxalt, Axert, Amerge y Relpax.

La FDA recientemente le solicitó a los fabricantes de estos tipos de medicamentos incluir etiquetas de advertencia en sus productos que alerten a las personas acerca del riesgo potencial del síndrome de la serotonina. Sin embargo, hable con el médico antes de suspender cualquier medicamento.

El síndrome de la serotonina es más probable que ocurra cuando uno comienza o incrementa el medicamento.

Los antidepresivos antiguos, llamados inhibidores de la monoaminoxidasa (IMAO) también pueden causar el síndrome de la serotonina con los medicamentos descritos arriba, al igual que meperidina (Demerol, un analgésico) o dextrometorfano (un antitusígeno).

Las drogas psicoactivas, como el éxtasis y el LSD han sido igualmente asociadas con el síndrome de la serotonina.

  • Reviewed last on: 6/30/2010
  • Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

US Food and Drug Administration. FDA Public Health Advisory: Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome. Rockville, MD: Center for Drug Evaluation and Research; July 19, 2006.

Prator BC. Serotonin syndrome. J Neurosci Nurs. 2006 Apr;38(2):102-5.

Ford MD, Clinical Toxicology. 1st ed. Philadelphia, Pa: WB Saunders; 2001:150, 522, 547, 550.

Bilden EF, Walter FG. Antidepressants. In Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006: chap 149.

Sternbach H. The Serotonin Syndrome. Am J Psychiatry. 1991: 148:705.

Parrot AC. Recreational Ecstasy/MDMA, the serotonin syndrome, and serotonergic neurotoxicity. Pharmacol Biochem Behav. 2002 Apr;71(4):837-44. Review.

Brent J, Palmer R. Monoamine oxidase inhibitors and serotonin syndrome. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 29.

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