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Published online by Cambridge University Press:  02 January 2018

Mark Ruddell*
Affiliation:
Division of Psychiatry, University of Nottingham, Duncan Mac-Millan House, Porchester Road, Nottingham NG3 6AA
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Abstract

Type
The Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2000

Sir Mir & Taylor (Psychiatric Bulletin, 23, 742-747) make an error in their article on serotonin syndrome. They start their article by stating that serotonin syndrome appears to be a new phenomenon; this is untrue. Serotonin syndrome is well-known to be an element of the carcinoid syndrome, a medical disorder characterised by high levels of circulating catecholamines due to inappropriate secretion by a tumour, for example, of the gut or adrenal medulla. This is not a drug side-effect.

The implications of this are potentially serious; a patient could present with the symptoms described without having a drug-induced serotonin syndrome, and the differential diagnosis is not discussed in this paper. The sections on ‘Causes of serotonin syndrome’ and ‘Biochemical mechanism of serotonin syndrome’ are, therefore, dangerously misleading. This could result in missed diagnoses of carcinoid syndrome, or misattribution of systemic serotonergic effects because other causes have not been considered.

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