Health Tips

Have you ever wondered what gives rise to the feeling of “happiness”? Yes, perhaps it’s that ice cream; a warm hug from someone you loved; or you’ve gotten what you long for after hard work. While our understanding of how our brain works is still relatively premature compared to other biological systems, we know a key brain chemical is closely linked to happiness, known as serotonin.

Serotonin, the ‘happy chemical’

Simply put, serotonin is the key hormone in the brain that stabilizes our mood, feelings of well-being, and happiness. Besides the brain, serotonin is also involved in many body systems.

Here are just a few of the many functions of serotonin in our body:

• Reduce blood pressure

• Control of hemostasis and platelet function, thereby affecting your blood clots

• Affect how the heart works

• Promote breathing

• Affect how our body uses energy 

• Sugar metabolism

• Maintain good digestive health

Serotonin be like:

Antidepressants - SSRIs

Antidepressants are medications used to treat depression. A type of antidepressants known as the selective serotonin reuptake inhibitors (SSRIs) mimics how serotonin works in our body and is commonly used in the treatment of depression. SSRIs work by stimulating the receptors of serotonin– as if giving the brain loads of serotonin to make it ‘happier’. Examples of SSRIs are:

• Citalopram

• Escitalopram

• Fluoxetine

• Fluvoxamine

• Paroxetine

• Sertraline

Antidepressants such as SSRIs are prescription medications and should strictly be prescribed by a medical doctor only. Do not attempt to purchase these medications from illegal channels.

Photo by Morgan Housel on Unsplash

Serotonin syndrome

What if one takes SSRIs more than required? It may result in serotonin syndrome. Also referred to as serotonin toxicity, is a potentially life-threatening condition where there is too much serotonin to the point of danger. 

Serotonin syndrome can lead to the following symptoms:

• Feeling anxious, restless, or confused

• Sweating

• Muscle spasms or muscles that cannot relax normally

• Very fast back-and-forth eye movements

• Shaking or trembling

• Fever

• A fast heartbeat

• Vomiting

• Diarrhea

The United States’ Toxic Exposure Surveillance System consistently reports tens of thousands of exposures to SSRIs, many of which involve serotonin syndrome. However, SSRIs are not the only culprit that leads to serotonin syndrome. 

Other medications that can cause serotonin syndrome

Besides SSRIs, the following medications may lead to serotonin syndrome as well:

• Some medicines used to treat Parkinson disease, such as selegiline and rasagiline 

• Some painkillers such as meperidine and tramadol

• St John’s wort, a herb that is commonly used for promoting sleep and treating depression

• Triptans, a group of medications commonly used for treating migraine

• Some antibiotics, such as linezolid 

• Street drugs, such as ecstasy, cocaine, and amphetamines

Doctors do not know why some people get serotonin syndrome and others do not. But they do know that people usually get it within hours of taking a new medicine or drug, a new dose, or a new combination of medicines or drugs.

It’s a medical emergency

Serotonin syndrome is a medical emergency. If you think you might have serotonin syndrome after starting a new medication recently, call your doctor immediately, visit an emergency room or call 999. There are treatments available at the hospital to treat serotonin syndrome.

A word from Doc2Us

If you have any questions related to serotonin syndrome, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. UpToDate - Serotonin syndrome (serotonin toxicity)

2. UpToDate - Selective serotonin reuptake inhibitors: Pharmacology, administration, and side effects

3. UpToDate - Patient education: Serotonin syndrome (The Basics)

4. Berger M, Gray J, Roth B. The Expanded Biology of Serotonin. Annual Review of Medicine. 2009;60(1):355-366.

Cover image credit: Photo by Morgan Housel on Unsplash

Written By

Ms Joyce Toh

Reviewed By

Doc2us Medical Board