Cerebral vasoconstriction and stroke after use of serotonergic drugs.
Serotonin (5-hydroxytryptamine) is a potent vasoconstrictor amine. The authors report three patients who developed thunderclap headache, reversible cerebral arterial vasoconstriction, and ischemic strokes (i.e., the Call-Fleming syndrome). The only cause for vasoconstriction was recent exposure to serotonergic drugs in all patients, and to pseudoephedrine in one patient. These cases, and the literature, suggest that the use of serotonin-enhancing drugs can precipitate a cerebrovascular syndrome due to reversible, multifocal arterial narrowing.
Singhal
A B
AB
Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA. asinghal@partners.org
Caviness
V S
VS
Begleiter
A F
AF
Mark
E J
EJ
Rordorf
G
G
Koroshetz
W J
WJ
D000328:Adult; D002545:Brain Ischemia / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology*; D004809:Ephedrine / Q000009:adverse effects; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017366:Serotonin Receptor Agonists / Q000009:adverse effects*; D014661:Vasoconstriction / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000009:adverse effects
D017366:Serotonin Receptor Agonists; D014662:Vasoconstrictor Agents; D004809:Ephedrine