Serotonin Syndrome/ Tinnitus

Most commonly attributed to SSRI, sometimes in overdose, sometimes with medication interactions resulting in higher effective dose. other times related to SSRI-similar drugs like tramadol. On test questions, often distinguished from NMS by hyper-reflexia. IMG

As discussed, antidepressants of different classes may function as inosine analgues. We have also discussed inosine-similar metabolites of cyproheptadine and cyclobenzaprine, which are also commonly associated with serotonin syndrome PMID XXXX. IMG

An unfortunately common ailment, with limited mechanistic understanding, often a side-effect of medication. There is a wide variety of drug classes of medications shown to cause and to improve tinnitus, suggesting that current classifications of medications are not indicative of the underlying mechanism e.g. "Both dopaminergic and antidopaminergic drugs have been proposed for treating tinnitus." PMID 19712015. Carbamazepine is associated with improvement PMID 20628627, as is pramipexole PMID 21433025: both seem to have effect increasing activity of PNP (conversion of Io to i, Xo to x, and Go to g), and are (therefore?) both used to treat Parkinsonian symptoms. L-DOPA has also been recommended for tinnitus (e.g. 19130969). As in Parkinsonian treatment, alcohol has an unclear effect, sometimes even beneficial PMID 21710223: as expected from induction of PNP as evidenced by increased hypoxanthine and xanthine. IMG