Table 5.
Mechanisms of serotonin excess.
| Result from Intrasynaptic Serotonin Excess | Drug 1 | |
|---|---|---|
| 1 | Increased synthesis | L-tryptophan |
| 2 | Increased release | Amphetamines, Cocaine, Ecstasy, Opioids |
| 3 | Decreased reuptake | TCA: Amitriptyline, Imipramine etc., SSRI: Sertraline, Fluoxetine, Citalopram etc., SNRI: Venlaflaxine, Duoxetine Other antidepressants: Trazodone Opioids: Fentanyl, Tramadol etc., |
| 4 | Decreased metabolism CYP inhibitors (CYP3A4, CYP2C19) |
MAOI: Moclobemide, Selegiline, Methylene blue Antibiotics/antimycotics: Linezolid, Ciprofloxacin, Fluconazole |
| 5 | 5-HT receptors agonists | LSD, Triptans, Mirtazapine, Buspirone |
| 6 | Increased 5-HT receptor sensitivity | Lithium |
| 7 | Others | Antiemetics: Metoclopramide, Ondasetron etc., Antimigraines: Carbamazepine, Triptanes Antiepileptics: Valproate |
1 SSRI Selective serotonin reuptake inhibitors, SNRI Serotonin noradrenalin reuptake inhibitors, TCA tricyclic antidepressants, MAOI Monoamine oxidase inhibitors. LSD Lysergic acid diethylamide.