Figure1
Fig. 1: Mechanisms of serotonin syndrome. (1) Increased doses of L-tryptophan will proportionally increase 5-hydroxytryptamine (5-HT or serotonin) formation. (2) Amphetamines and other drugs increase the release of stored serotonin. (3) Inhibition of serotonin metabolism by monoamine oxidase (MAO) inhibitors will increase presynaptic 5-HT concentration. (4) Impairment of 5-HT transport into the presynaptic neuron by uptake blockers (e.g., selective serotonin reuptake inhibitors, tricyclic antidepressants) increases synaptic 5-HT concentration. (5) Direct serotonin agonists can stimulate postsynaptic 5-HT receptors. (6) Lithium increases postsynaptic receptor responses. Adapted with permission from Elsevier Science (Critical Care Clinics 1997;13[4]:763-83). Photo: Chesley Sheppard
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