Serotonergic drugs

Cerebral ischaemia - Serotonergic drugs Factor

Serotonergic drugs used in combination or in overdose can lead to a clinical condition known as Serotonin syndrome.  The syndrome is caused by excessive central nervous system and peripheral serotonergic activity.  A combination of agents increasing serotonin by different mechanisms, such as by inhibition of serotonin uptake and serotonin metabolism, is associated with a high risk of the syndrome.  The syndrome often occurs within 24 hours of a change of treatment (increase in dose or addition of another serotonergic agent) and the evolution of symptoms is rapid.  Such symptoms may include confusion, convulsions, hypertension, hallucinations or delirium.  The table below highlights examples of serotonergic drugs reported by the Therapeutic Goods Administration (TGA) as causing serotonin syndrome.

Last reviewed for CCPS 24 May 2007.

Investigative Documents

Preliminary questions [37127]

37128 there is some evidence that taking serotonergic drugs as specified may be a factor in the development of the condition under consideration, a cerebrovascular accident.

37130 the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37137  the veteran has established the causal connection between taking serotonergic drugs as specified and VEA service for the clinical onset of cerebrovascular accident.

37138   the veteran has established the causal connection between taking serotonergic drugs as specified and operational service for the clinical onset of cerebrovascular accident.

or

37139   the veteran has established the causal connection between taking serotonergic drugs as specified and eligible service for the clinical onset of cerebrovascular accident.

Clinical onset and operational service [37138]

37131 on operational service, the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37132 the veteran's use of serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident on operational service within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

37133 the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, for treatment of an illness or injury which is identifiable.

37135  the identified illness or injury, for which the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, is causally related to operational service.

Clinical onset and eligible service [37139]

37133 the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, for treatment of an illness or injury which is identifiable.

37136  the identified illness or injury, for which the veteran took serotonergic drugs as specified in the Statements of Principles for cerebrovascular accident within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, is causally related to eligible service.