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Pharmaceuticals/Seratonin Syndrome

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Question
A few months ago I started taking Lexapro. I immediately responded in what I feared would become seratonin syndrome, and ceased taking the drug. I have recently been prescribed Remeron. Isn't the pharmacology between the two drugs similar? I am very concerned that I might experience the same effects with Remeron as I did with Lexapro. Thanks for your time Dr. Salman.

Answer
Escitalopram is a Selective Serotonin Reuptake inhibitor while Mitrazapine (Remeron) is an antagonist/inverse agonistat Serotonin receptors. So, it does not result in any incidence of serotonin-related toxicity. In addition, a case report claimed that mirtazapine can actually be used to treat serotonin syndrome.
See:
Gillman PK (June 2006). "A review of serotonin toxicity data: implications for the mechanisms of antidepressant drug action". Biol. Psychiatry 59 (11): 104651.
Hoes MJ, Zeijpveld JH (March 1996). "Mirtazapine as treatment for serotonin syndrome". Pharmacopsychiatry 29 (2): 81

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Dr Mohd Tariq Salman

Expertise

I can answer questions related to indications (therapeutic uses), contraindications, adverse reactions and interactions of drugs. I can also give expert opinion on queries related to rational use of medicines, including cost effective medication, essential medicines and generic drugs.

Experience

Teaching and training of undergraduate medical, dental and pharmacy students, supervision of pharmacology residents and research on herbal drugs, pharmacovigilance and drug utilization studies.

Organizations
Era's Lucknow Medical College, Jawaharlal Nehru Medical College, Indian Pharmacological Society, Society of Pharmacovigilance India, Association of Medical Pharmacologists of Imdia.

Publications
British Journal of Clinical Pharmacology, JK Science, Natural Product Radiance, Hippocratic Journal of Unani Medicine, Indian Journal fot the Practicing Doctor, Unimed Kulliyat.

Education/Credentials
MBBS, MD (Pharmacology)

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