O que é a síndrome da serotonina e o que a causa?

O que é a síndrome da serotonina?

Serotonina - also known as 5-hydroxytryptamine, or 5-HT - is a chemical that functions as a neurotransmitter to carry signals between nerve cells throughout your body. In the brain, serotonin helps to regulate humor e memória, mas também tem outros papéis importantes, como auxiliar na digestão.

Serotonin's effect on mood is why it's often a target of medications that are used to treat saúde mental conditions. For example, increasing serotonin levels is the purpose of the class of antidepressivos known as inibidores seletivos da recaptação de serotonina (SSRIs). However, it is possible for serotonin levels to become too high - so-called serotonin syndrome.

"Serotonin is a chemical which is naturally produced in the body and is required for nerve cells and the brain to function," says Dra. Natasha Bijlani - consultant psychiatrist at the Hospital Priory Roehampton Londres.

"Too much serotonin leads to the development of a set of potentially dangerous symptoms called serotonin syndrome. Serotonin syndrome usually occurs as a result of taking medicamentos that cause high levels of serotonin to accumulate in the body," she explains. "Serotonin syndrome can be a life-threatening condition and should be regarded as a medical emergency. It requires immediate treatment."

O que causa a síndrome da serotonina?

SSRI antidepressivos are the most commonly prescribed class of drugs for moderate to severe depression. They can be extremely effective, especially when used alongside other treatments like terapia de conversa.

However, serotonin syndrome can occur if someone overdoses on their antidepressivos, ou se tomarem diferentes tipos de medicamentos antidepressivos ao mesmo tempo.

"SSRIs work by increasing the availability of serotonin in the brain and other parts of the body," explains Bijlani. "But if multiple ISRSs are prescribed at the same time or used in conjunction with other serotonin-enhancing medications or substances, then the risk of serotonin syndrome is enhanced."

Pesquisa has shown that various types of antidepressant, including ISRSs, serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressivos and monoamine-oxidase inhibitors (MAOIs), been linked to serotonin syndrome.

"Alguns casos podem surgir após uma única dose de um inibidor seletivo da recaptação de serotonina (ISRS). Também pode ocorrer quando a dose de um medicamento que atua nos níveis de serotonina é aumentada ou um novo medicamento é adicionado", ela diz. "Alguns suplementos alimentares e drogas recreativas também têm sido associados ao desenvolvimento da síndrome serotoninérgica."

Illicit drugs such as cocaine, LSD, amfetamines and ecstasy can affect serotonin levels. Medicamentos triptanos used to treat migraines, and herbal supplements such as Erva de São João, can also have an effect. On rare occasions, some over-the-counter resfriado para resfriado can also interact with antidepressants, which may risk increasing serotonin levels.

Quais são os sintomas da síndrome serotoninérgica?

"Serotonin syndrome symptoms develop within six hours of initial use, change in dose or following overdose," says Bijlani. "Initial serotonin syndrome symptoms are usually mild and include diarreia, shivering and feeling more ansioso, agitated and restless. Serotonin syndrome symptoms also include insônia, dores de cabeça, rigid muscles, mild febre and developing goosebumps."

Worsening serotonin syndrome symptoms lead to the development of increased heart rate and a pressão arterial, dilated pupils, loss of muscle co-ordination and twitching, alongside heavy sudorese and confusion.

"Signs of severe serotonin syndrome include high fever, convulsões, batimento cardíaco irregular com perda de consciência e eventualmente possível morte," diz Bijlani.

Como evitar a síndrome da serotonina

Prescription medication such as ISRSs should always be taken at doses recommended by your doctor.

"People should be made aware of the possible risk of síndrome syndrome and what to do if they develop any of the signs and symptoms," says Bijlani. "One should never increase the dose of any medication, or take any additional medications or supplements, without talking to their doctor first."

Se você está preocupado que tenha síndrome serotoninérgica, é importante procurar ajuda médica o mais rápido possível.

"A síndrome serotoninérgica é considerada uma emergência médica. Os sintomas da síndrome serotoninérgica podem escalar rapidamente e levar a consequências perigosas," diz Bijlani. "Qualquer pessoa que suspeite estar desenvolvendo tais sintomas deve procurar assistência médica urgente.

"Serotonin syndrome treatment involves monitoring for vital physical signs and stopping all medications that could be contributing to elevated serotonin levels," she adds. "It might involve managing agitation with suitable medication, reducing body temperatura and the consideration of intensive-care treatment if severe serotonin syndrome has developed."