Serotonin irritation syndrome: an hypothesis.

Two patients were seen with multisystememic complaints and anxious feelings. Their history was similar for chronic exposure to potentially ionized atmospheric environments--a waterfall and high-voltage equipment. Physical examination showed various signs sometimes associated with hyperserotonergic states. Laboratory testing showed increased levels of serum serotonin and decreased levels of its metabolite, urinary 5-hydroxyindoleacetic acid (5-HIAA). Removal of the patients from these environments or the use of a serotonin-blocker ameliorated all symptoms and reestablished normal serotonin and 5-HIAA levels. A literature-review disclosed a similar symptom-complex reported with air-ionization during the sweep of hot winds across desert lands. Animal studies are cited in which cation aerosols are used to block serotonin metabolism, producing clinical and laboratory results some of which are similar to those seen in the patients described. It is suggested that a "serotonin irritation syndrome" might be related to cation-induced serotonin metabolic dysfunctions.