{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:35:18Z","timestamp":1792254918580,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Basic Clin Pharma Tox"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Serotonin syndrome is a potentially life\u2010threatening syndrome with manifestations spanning from mild adverse effects to life\u2010threatening toxicity. The syndrome is caused by overstimulation of serotonin receptors by serotonergic drugs. Since the use of serotonergic drugs is increasing, primarily due to the widespread use of selective serotonin reuptake inhibitors, cases of serotonin syndrome have likely seen a parallel increase. The true incidence of serotonin syndrome remains unknown due to its diffuse clinical presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This review aims to provide a clinically focused overview of serotonin syndrome, covering its pathophysiology, epidemiology, clinical manifestations, diagnostic criteria, differential diagnosis and treatment, as well as classifying serotonergic drugs and their mechanism of action. The pharmacological context is emphasized, as it is crucial for the detection and management of serotonin syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Focused review based on a literature search using the PubMed database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings and conclusion<\/jats:title><jats:p>Serotonin syndrome can occur through therapeutic use or overdose of a single serotonergic drug or as a drug interaction between two or more serotonergic drugs. Central clinical features consist of neuromuscular excitation, autonomic dysfunction and altered mental status, occurring in a patient undergoing new or altered serotonergic therapy. Early clinical recognition and treatment are crucial to prevent significant morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcpt.13912","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T06:20:49Z","timestamp":1686637249000},"page":"124-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Serotonin syndrome\u2014A focused review"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6020-0844","authenticated-orcid":false,"given":"Nicolaj","family":"Mikkelsen","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research, Faculty of Health Science University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-7187","authenticated-orcid":false,"given":"Per","family":"Damkier","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research, Faculty of Health Science University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-9092","authenticated-orcid":false,"given":"Sidsel Arnspang","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research, Faculty of Health Science University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20092288"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg109"},{"issue":"4","key":"e_1_2_10_5_1","first-page":"533","article-title":"Serotonin syndrome","volume":"13","author":"Volpi\u2010Abadie J","year":"2013","journal-title":"Ochsner J"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2021.000032"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2007.09.007"},{"issue":"2","key":"e_1_2_10_8_1","first-page":"178","article-title":"Pharmacology of 5\u2010hydroxytryptamine\u20101A receptors which inhibit cAMP production in hippocampal and cortical neurons in primary culture","volume":"33","author":"Dumuis A","year":"1988","journal-title":"Mol Pharmacol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1626"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.11.016"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0006\u20108993(00)03020\u20101"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178646919873925"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1081\/clt\u2010120037428"},{"key":"e_1_2_10_14_1","volume-title":"StatPearls","author":"Simon LV","year":"2022"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08443"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792\u2010200007000\u201000001"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.17m02200"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2022.08.030"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12543"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370204700106"},{"key":"e_1_2_10_21_1","first-page":"1163","article-title":"Clinical pharmacology of atypical antipsychotics: an update","volume":"13","author":"Mauri MC","year":"2014","journal-title":"EXCLI j"},{"issue":"3","key":"e_1_2_10_22_1","first-page":"526","article-title":"Neuroleptic malignant syndrome or serotonin syndrome?","volume":"34","author":"Nagamine T","year":"2022","journal-title":"Psychiatr Danub"},{"key":"e_1_2_10_23_1","first-page":"337","volume-title":"The Maudsley Prescribing Guidelines in Psychiatry","author":"Taylor DM","year":"2018"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000344"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1D344"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.17r02185"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.6.884a"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2019.014"}],"container-title":["Basic &amp; 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