Study summary · research use only
The role of methylene blue in serotonin syndrome: a systematic review
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This systematic review examined the role of methylene blue (MB) in serotonin syndrome in humans. The authors describe a series of case reports demonstrating a previously unrecognized drug interaction between serotonin reuptake inhibitors (SRIs) and MB, and review case reports and clinical audits relevant to this interaction. Articles were obtained from a systematic search of MEDLINE and PsychInfo and from bibliographies, with studies considered relevant if the patient received MB and developed an acute confusional state, neuropsychiatric complications, or autonomic instability. The review identified nine case reports and two retrospective reviews; 26 patients developed an acute confusional state after MB infusion, 24 of whom were taking an SRI and 1 clomipramine, with serotonin syndrome a possible diagnosis in 25. The authors conclude SRIs can interact with MB.
Abstract
A recent series of case reports has demonstrated a significant, previously unrecognized drug interaction between serotonin reuptake inhibitors (SRIs) and methylene blue (MB). The authors review the case reports and clinical audits relevant to this interaction and consider the diagnosis of serotonin syndrome in these cases. Articles were obtained from a systematic search of MEDLINE and PsychInfo databases, and from the bibliographies of relevant articles. Studies were considered relevant if the patient received MB and developed an acute confusional state, neuropsychiatric complications, or autonomic instability. The review identified nine case reports and two retrospective reviews; 26 patients developed an acute confusional state after MB infusion; 24 of these patients were taking an SRI, and 1 was taking clomipramine. Serotonin syndrome was a possible diagnosis in all 25 of these patients. SRIs can interact with MB, causing a serious adverse reaction consistent with serotonin syndrome.
pepmg summarizes the peer-reviewed literature and links to every source — it sells nothing, ships nothing, and gives no medical, dosing, or human-use guidance. Don't just trust this summary: follow the citation to its source and read it yourself. Research use only.