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A correction has been published: N Engl J Med 2007;356(23):2437.

A correction has been published: N Engl J Med 2009;361(17):1714.

Review Article
Current Concepts
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Volume 352:1112-1120 March 17, 2005 Number 11
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The Serotonin Syndrome
Edward W. Boyer, M.D., Ph.D., and Michael Shannon, M.D., M.P.H.

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The serotonin syndrome is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, intentional self-poisoning, or inadvertent interactions between drugs. Three features of the serotonin syndrome are critical to an understanding of the disorder. First, the serotonin syndrome is not an idiopathic drug reaction; it is a predictable consequence of excess serotonergic agonism of central nervous system (CNS) receptors and peripheral serotonergic receptors.1,2 Second, excess serotonin produces a spectrum of clinical findings.3 Third, clinical manifestations of the serotonin syndrome range from barely perceptible to lethal. The death of an 18-year-old patient named Libby Zion in New York . . . [Full Text of this Article]

Definition and Epidemiology

Manifestations

Pathophysiology and Molecular Mechanisms

Diagnosis

Management

Prevention


Source Information

From the Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts, Worcester (E.W.B.); and the Program in Medical Toxicology, Division of Emergency Medicine, Children's Hospital, Boston (E.W.B., M.S.).

This article (10.1056/NEJMra041867) was updated on October 21, 2009, at NEJM.org.

Address reprint requests to Dr. Boyer at IC Smith Bldg., Children's Hospital, 300 Longwood Ave., Boston, MA 02115, or at edward.boyer@tch.harvard.edu.


Related Letters:

The Serotonin Syndrome
Basu D., Gillman P. K., Gnanadesigan N., Espinoza R. T., Smith R. L., Claassen J. A.H.R., Gelissen H. P.M.M., Boyer E. W., Shannon M.
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N Engl J Med 2005; 352:2454-2456, Jun 9, 2005. Correspondence

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