Easily annoyed, Delirium, Change, Fits, Restlessness, Increased heart rate, Sweating, Shivering, Tremor, Mental status changes, Restlessness, Increased reflexes, Increased reflexes, Stiffness, Shaking, Pain in the belly, Diarrhoea, Perspiring, Increased temperature, High blood pressure. Just about all these are signs or symptoms of serotonin syndrome. All may look generally within the first day following taking an overdose of serotonin drugs.

This symptoms are on cognitive stage, visceral nervous system level as well as SoNS level.

Serotonin Syndrome appear usually after overdose of serotonin drugs and drug combination that increase synaptic serotonin. Drugs that are know to stimulate high levels of serotonin are: MAOIs, TCAs, SSRIs, SNRIs, Bupropion, Tramadol, Fentany, Oxycodone, Hydrocodone, MDMA, MDA, Pep pill, Sibutramine, Cocaine, Triptans, LSD, Panax Ginseg, Nutmed, Yohimbe, Syrian Rue, Ritonavir, Granisetron, Olanzapine, Valproate, Buspirone, Li, Linezolid, Dextromethorphan, Risperidone, Trypthophan, L-Dopa, Valproate, Amphetamine.

Due to the fact serotonin syndrome it's certainly not tested in the laboratory for diagnosis, symptoms are the one that need seen. The best set of criteria to use to diagnose serotonin toxicity is Hunter Serotonin Toxicity Criteria.

Treatment for serotonin syndrome tend to be as follows:

discontinuing drugs that produced the overdose posible and also drugs which can contribute

management of serotonin antagonist (eg. cyproheptadine) for sever cases of toxicity

for agitation, muscle mass stiffness and also seizure like movements, benzodiazepines (Valium, Ativan)

Intra venous fluids

Considering that serotonin syndrome is not easy to diagnose, protection is needed for any serotonin drugs combination that will cause serotonin toxicity.

Dunkley, EJ, Isbister, GK, Sibbritt, D, Dawson, AH, Whyte, IM, The Hunter Serotonin Toxicity Criteria:  simple and accurate diagnostic decision rules for serotonin toxicity, QJM 2003; 96:635-642

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.

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