Cerebral vasoconstriction and stroke after use of serotonergic drugs

Neurology. 2002 Jan 8;58(1):130-3. doi: 10.1212/wnl.58.1.130.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Ischemia / chemically induced*
  • Brain Ischemia / pathology
  • Brain Ischemia / physiopathology
  • Cerebral Arteries / pathology
  • Cerebral Arteries / physiopathology*
  • Ephedrine / adverse effects
  • Female
  • Headache / chemically induced
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Serotonin Receptor Agonists / adverse effects*
  • Vasoconstriction / drug effects*
  • Vasoconstrictor Agents / adverse effects

Substances

  • Serotonin Receptor Agonists
  • Vasoconstrictor Agents
  • Ephedrine