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Serotonin toxicity from antidepressant overdose and its association with the T102C polymorphism of the 5-HT2A receptor

The Pharmacogenomics Journal volume 14, pages 390–394 (2014)Cite this article

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Abstract

Serotonin toxicity results from serotonin excess in the central nervous system from serotonergic drugs. Previous studies suggest an association between T102C polymorphism of the serotonin 2A (5-hydroxytryptamine 2A) receptor gene and serotonergic adverse effects with serotonergic drugs. We aimed to determine whether there is an association between the T102C polymorphism and serotonin toxicity in patients taking serotonergic drug overdoses. Ninety-five patients presenting with serotonergic drug overdoses were examined for serotonin toxicity and had blood collected for DNA analysis. A diagnosis of serotonin toxicity was made in 14 patients (15%) based on the Hunter Serotonin Toxicology Criteria. Four of the 14 patients (29%) with serotonin toxicity had the C/C genotype compared with 20/81 (25%) without serotonin toxicity. There were no differences in age or sex, but the median defined daily dose taken by patients with serotonin toxicity was 27 (14–84) compared with 18 (2–136) in patients without serotonin toxicity (P=0.06). There was no association between serotonin toxicity and the T102C polymorphism in patients taking a serotonergic drug overdose.

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Acknowledgements

We thank Pavel Bitter from the Australian Cancer Research Foundation Unit (ACRF), Garvan Institute, Sydney, NSW, Australia for assistance with DNA analysis. The study was supported in part by a Near Miss grant from the University of Newcastle. We thank Debbie Whyte and Antonia Nash for data entry in the clinical database. We thank Renai Kearney for administrative assistance and obtaining medical records. GKI is supported by an NHMRC Clinical Career Development Award ID605817.

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Authors and Affiliations

  1. Discipline of Clinical Pharmacology, University of Newcastle, Waratah, NSW, Australia

    J M Cooper, D A Newby, I M Whyte & G K Isbister

  2. Discipline of Pharmacy and Experimental Pharmacology, University of Newcastle, Newcastle, NSW, Australia

    J M Cooper

  3. Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Waratah, NSW, Australia

    I M Whyte & G K Isbister

  4. Department of Liaison Psychiatry, Calvary Mater Newcastle, Waratah, NSW, Australia

    G Carter

  5. Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia

    A L Jones

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Correspondence to G K Isbister.

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Cooper, J., Newby, D., Whyte, I. et al. Serotonin toxicity from antidepressant overdose and its association with the T102C polymorphism of the 5-HT2A receptor. Pharmacogenomics J 14, 390–394 (2014). https://doi.org/10.1038/tpj.2013.47

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