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Created with Fabric.js 1.4.5 Symptoms of acute toxicity Treatment Rapid HeartRate Loss of MuscleCoordinationand Muscle Ridgity Serotonin Toxicity Headache and Shivering Benzodiazepines,muscle relaxants, control agitation,seizures, muscle stiffness Serotonin-production blocking agents, such ascyproheptadine Intravenous fluidsand supplementaloxygen to combatdehydration and hypoxemia. Cause of Neurotoxicity in Serotonin releasers (2 Possibilities) Many Serotonin Releasers are substituted amphetamines, many of which metabolized into α-Me-DA, a potent neurotoxin α-Me-DA functions by causing oxidative stress in neurons α-Me-DA also reduces overall serotonin in the brain inducing the same symptoms as below The flooding of the brain with serotonin, dopamine and norepinephrine causes a lasting reduction in SERT markers as well as long term memory impairment The exact mechanism is not known, however it involves the simultaneous release of dopamine and serotonin, since MDAI (a drug that only releases serotonin) doesn't cause neurotoxicity Reduction of SERT markers (low levels of serotonin) isassociated with aggressive behavior, suicide by violent means, and depressive symptoms MDMA(Releasing Agent) Methylone(Releasing Agent) Agitation and Restlessness Heavy Sweating Methamphetamine Tianeptine (Tricyclic antidepressant) Both types of neurotoxicity are compounded by an increase in ambient temperature Hallucinations Drugs that may cause Serotonin Syndrome Citalopram (SSRI) Inhibition of Serotonin Reuptake (SSRI, Tricyclics, etc.) Inhibition of Serotonin Metabolism by MAO(MAOI: beta-carbolines, etc.) Stimulation ofSerotonin Receptors(LSD, lithium, triptans, etc.) Increased Serotonin Production (L-tryptophan) IncreasedSerotonin Release (MDMA, DXM, etc.) Dextromethorphan(Reuptake Inhibitor) alpha-methyl-Dopamine Eletriptan(Triptan) Serotonergic drugs are the most universally used class of drugs throughout the world. In 2012, it is estimated that 18.75 million people consumed some form of MDMA, and 34.40 million consumed a substituted amphetamine. According to the IMS report in 2010 over 253.6 million antidepressent prescriptions were filled. Due to thewide spread use of these drugs in both medicinal andrecreational settings, it is wise to take stock of their side effects and possible complications that can result from the many classes of serotonergic drugs. Serotonin Syndrome (excessive serotonin levels) can be caused bymixing drugs, stopping the consumption of SSRI's, and releasing agent overdoses
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