SynthesisEuropean journal of clinical pharmacology2026
Precipitants and clinical features of serotonin syndrome: a systematic review with patient-level analysis of published case reports and series.
Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Precipitants and clinical features of serotonin syndrome: a systematic review with patient-level analysis of published case reports and series.European journal of clinical pharmacology · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerotonin syndrome (SS) is a concern for prescribers of serotonergic acting agents and mainly antidepressants, yet the implicated drug combinations and associated outcomes across clinical settings remain incompletely characterized.
methodsWe performed a systematic review in PubMed/Embase, searching for SS cases in adults from the database's inception until June 2024, and conducted a patient-level and network analysis of drug co-occurrence. The quality of SS diagnoses was assessed using the Hunter Serotonin Toxicity and the Sternbach Criteria.
resultsA total of 764 cases were included; 653 (85.6%) and 496 (65.0%) met the Sternbach and the Hunter Criteria, respectively. Patients with SS following suicide attempts were more frequently admitted to intensive care units with higher mortality rates than patients with SS related to regular prescriptions (79.4% vs 35.6% and 18.0% vs 5.1%, respectively, both p < 0.001). Of 645 regular prescription cases, 92.9% were drug combinations (≥ 2 agents). Monotherapy cases were milder and often occurred after initiation of a new antidepressant in younger patients. Drug combinations involved non-antidepressants in 90.7%. Network analysis identified trazodone as the most connected antidepressant, and fentanyl and tramadol as the most connected non-antidepressant nodes. We identified five SS cases following antipsychotic discontinuation while maintaining serotonergic agents.
conclusionsNon-suicidal cases of SS during regular prescription were less serious than SS cases associated with intentional overdose. The emerging role of non-antidepressant agents (e.g., several opioids and antiparkinsonian drugs) as potential precipitants support tailored interprofessional medication review in poly-medicated subjects.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.