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Serotonin Syndrome–Inducing Agents SIADH Causes: Mnemonic 1281

Serotonin Syndrome–Inducing Agents
VetBooks.ir Agent General Comments

Foods or supplements: • L-5-HTP is an OTC supplement used in humans for depression, insomnia; serotonin syndrome (SS)
L-5-HTP, L-tryptophan, Griffonia seed extract reported as a result of accidental ingestion in dogs.
Aged cheese, chicken liver • Tyramine present in certain foods can interfere with MAO inhibitors’ action and enhance their toxicity.
Medications that increase presynaptic release of serotonin: • In addition to CNS excitation from amphetamine, signs of confusion, disorientation, hallucination, and
Amphetamine rigidity may be due to SS.
Methylphenidate • SS is a clinical entity characterized by presence of some GI signs, CNS signs (hyperreflexia, tremors,
Ecstasy (MDMA; 3,4-methylenedioxymethamphetamine) rigidity, confusion, agitation, excitation, seizures), and mydriasis, tachycardia, hyperthermia.
Bromocriptine • SS can be seen with acute large overdose or with repeated therapeutic treatment.
L-dopa • Cyproheptadine, 1.1 mg/kg for dogs and 2-4 mg/CAT PO or per rectum q 6-8h, can be used for
treating signs of SS; discontinue after 2-3 treatments if no relief.
Presynaptic reuptake inhibitors, selective serotonin reuptake
inhibitors (SSRIs), and tricyclic antidepressants: • Chlorpromazine and other phenothiazines possess some antiserotonin effects.
Fluoxetine • Selegiline recommended for use in dogs for cognitive dysfunction. Interaction likely when selegiline
Bupropion used concurrently with tricyclic antidepressants, amitraz, meperidine, or SSRIs.
Duloxetine
Fentanyl
Pethidine
Paroxetine
Sertraline
Citalopram
Fluvoxamine
Amitriptyline
Clomipramine
Tramadol Differentials, Lists,
Chlorpheniramine and Mnemonics
Venlafaxine
Dextromethorphan
Meperidine
Serotonin metabolism inhibitors:
Selegiline (MAO-B inhibitor; Anipryl)
Amitraz
Serotonin agonists at postsynaptic membrane:
Buspirone
Lithium
LSD (lysergic acid diethylamide)
CNS, Central nervous system; GI, gastrointestinal; MAO, monoamine oxidase; OTC, over-the-counter.
From Crowell-Davis SL, Poggiagliolmi S: Understanding behavior: serotonin syndrome. Compend Contin Educ Vet 30:490-493, 2008; Mohammad-Zadeh LF, Moses L, Gwaltney-Brant SM: Serotonin: a
review. J Vet Pharmacol Ther 31:187-199, 2008.

SIADH Causes: Mnemonic

S—surgery
I—intracranial disease
A—alveolar (lung disease)
D—drugs (e.g., opiates, cytotoxic drugs, anticonvulsants)
H—hormonal (hypothyroid, hypoadrenocorticism)
SIADH, Syndrome of inappropriate antidiuretic hormone.

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