Serotonin syndrome: Is it fatal?

The biological processes in our body are conducted with a high degree of balance and accuracy. Increasing or decreasing a single substance in the body leads to a large defect resulting in disorders or diseases, or even death. One of these substances is, for example, serotonin, which you may not touch its role in regulating your body, but of course you will touch its glitch that may lead you to hell!
However, we know that serotonin is a neurotransmitter, allowing the exchange of signals between neurons and regulating them. It also plays an important role in the central nervous system and in the overall functioning of the body, especially the digestive system. What is important to mention here is that, serotonin regulates bowel function and movement as well as helping to block appetite while eating. For instance, when you are eating something toxic or inappropriate, the gut produces more serotonin to increase transit time and facilitate the release of these substances through diarrhoea and nausea. On the other hand, Serotonin in the brain regulates mood, memory, sleep, desire and function, body temperature, anxiety and happiness besides other related functions.
Unfortunately, nowadays with many cases of depression and psychiatric illness, certain medications have been implemented in the treatment of such disorders. We should know that low serotonin level in the body leads to poor memory and bad mood. In addition to other symptoms, such as the desire to eat sweet and starchy foods, difficulty sleeping, self-contempt, anxiety and aggressive tendencies.
However, I should express that these symptoms indicate depression, so serotonin is not primarily responsible for depression and a lack of serotonin may be a cause of depression only in people who are most likely to develop it. But the basic theory of the last 50 years is that the imbalance in neurotransmitters or hormones in the body leads to depression. Depression is related to a decrease in serotonin in the body, but it is not yet clear whether low serotonin leads to depression, or is it the depression itself that leads to a decrease in serotonin.
In fact, The Food and Drug Administration (FDA) have approved the use of a group of medications named (SSRIs) as antidepressants. Normally, once a neurotransmitter transmits a nerve impulse, the body absorbs it again, these SSRIs prevent serotonin from being reabsorbed, increasing the proportion of serotonin in neurological clashes. But how exactly? This is not yet known. Scientists have suggested that although these inhibitors do work with some people, they are unlikely to increase serotonin levels or directly improve depressive symptoms.
Sadly, some thought that high serotonin levels were desirable or can bring happiness, but in reality it is a misconception of course. Serotonin can become fatal when a person develops serotonin syndrome, looking to high serotonin level in the body, as a result of overdose of some agents, as well as some illegal drugs and supplements. Recent evidence suggests that the incidence of serotonin syndrome is increasing alongside the increasing use of antidepressants. However, there are plenty of substances that increase serotonin levels in addition to antidepressants, for instance, migraine, anticonvulsive, opioid pain medications, in addition to other agents.
Serotonin syndrome occurs when people take one or more prescription medications, supplements, or illicit drugs that increase serotonin levels. Actually, the symptoms of serotonin syndrome range from simple (tremor & diarrhoea) to severe symptoms (muscle stiffness, fever, seizures) and to death in the absence of treatment.
Although this syndrome can occur when you take a single drug that causes high serotonin levels, it most often occurs when certain medications are combined together as mentioned earlier. For example, it can occur when taking antidepressants with either migraine medication or with pain-relieving medications.
Symptoms appear within several hours after taking the medications and increasing their dose. It includes: agitation or insomnia, delirium, high heart rate, high blood pressure, pupil dilation, loss of muscle coordination or tingling, muscle stiffness, severe sweating, diarrhoea, headache and trembling.
Definitely what I would point here, that in case you express any symptoms of irregular heartbeats, overheating and loss of consciousness, may be a bad omen that the serotonin level is so high that it threatens your life.
Hence, keep in mind, that symptoms of serotonin syndrome usually resolve on their own, once a person stops taking the medication or substance responsible for the problem. Despite that, those who have life-threatening symptoms of serotonin syndrome may require hospitalisation and ongoing monitoring.
On the other hand, the body needs an amino acid named L-TRYPTOPHAN, in order to synthesise serotonin. So, in order to increase the mood effects of serotonin, humans must eat foods high in amino acid (L-TRYPTOPHAN) compared to total protein, such as: sesame, pumpkin, soy foods, seeds, cheeses, mutton, chicken and salmon. When you change your daily habits, the serotonin ratio will change and rise again. So, a change in the level of serotonin is a response to what the body does.

Dr Yousuf Ali al Mulla, MD, Ministry of Health, is a medical innovator and educator. For any queries regarding the content of the column he can be contacted at: