Internal medicine

Receptor

Serotonin

Tramadol

Serotonergic

Opioid

Serotonin syndrome

5-HT receptor

Analgesic

Reuptake inhibitor

Anesthesia

Monoaminergic

Medicine

Pharmacology

British Journal of Anaesthesia

Most cases of serotonin toxicity are provoked by therapeutic doses of a combination of two or more serotonergic drugs, defined as drugs affecting the serotonin neurotransmitter system. Common serotonergic drugs include many antidepressants, antipsychotics, and opioid analgesics, particularly fentanyl, tramadol, meperidine (pethidine), and methadone, but rarely morphine and other related phenanthrenes. Symptoms of serotonin toxicity are attributable to an effect on monoaminergic transmission caused by an increased synaptic concentration of serotonin.

The anaesthetist, opioid analgesic drugs, and serotonin toxicity: a mechanistic and clinical review