Monoaminoxidase inhibitors as a cause of serotonin syndrome – a systematic case review based on meta-analytic principles

Introduction Serotonin syndrome (SS) is a toxic state characterized by increased serotonin activity. It has been suggested that severe usually involves monoaminoxidase inhibitors (MAOIs). Objectives To quantify in how far SS associated with MAOIs. Methods Systematic review and quantitative analysis of all cases published between 1 January 2004 31 December 2014. Severe was defined as cases, either requiring intensive care or resulting death. Cases were included if they met the diagnostic criteria for according to at least one three systems (Hunter, Radomski Sternbach). Results Of 299 118 (39%) definition SS. Eight had insufficient information enable severity classification. 48 (40%) involved MAOI. these, 67% related psychiatric MAOIs, such phenelzine moclobemide 33% somatic MAOI, methylene blue linezolid. remaining 173 non-severe 24 (13%) In 12% MAOI 83% One case (4%) combination both. The odds ratio involvement versus 4.3 (CI 2.4 – 7.5; p < 0.001). Conclusions majority reports, drugs other than MAOIs are syndrome, even cases. are, however, more common Conflict interest M. Ott: scientific advisory board member Astra Zeneca, Sweden. U. Werneke: received funding educational activities on behalf Norrbotten Region; Eli Lilly, Janssen, Novartis, Otsuka/Lundbeck, Servier, Shire, Sunovion. Others: None