Table 3.

Common Medicines associated with Serotonin Syndrome

Mechanism	Drugs
Increased serotonin Formation	Tryptophan
Increases release of serotonin	Amphetamine, cocaine, levodopa
Impairs reuptake in junction	TCA, SSRI, SNRI, St John’s wort, 5-HT3 antagonist, Dextromethorphan, Metoclopramide, Tramadol, Cyclobenzaprine
Decreased Metabolism	MAOI
Direct agonist	Tryptans, Fentanyl

TCA: tricyclic antidepressant, SSRI: selective serotonin reuptake inhibitor, SNRI: selective norepinephrine reuptake inhibitor, MAOI: monoamine oxidase inhibitor, 5-HT3: 5-hydroxytryptophan type 3.