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Serotonin Syndrome
Poly-pharmacy or the use of multiple drugs to treat a condition has always been a situation that bears watching. In some conditions drugs are purposely prescribed in combination in order to create a synergistic affect - leading to a more effective outcome in symptom management or resolution.
There are times however, when a combination of drugs can be lethal if not watched carefully. In these situations, it is important for doctors to have a heightened awareness of these potential complications and avoid prescribing such combinations for their patients.
One condition that seems to be on the rise again is serotonin syndrome and it is seen most often in patients being treated for migraine headaches because of the combination of drugs involved. This syndrome is a result of too much serotonin in the body and it presents with a variety of symptoms that resemble neuroleptic malignant syndrome--a serious condition seen in patients taking neuroleptic drugs.
This article is very good as well. It has a bit more clinical information related recognition and management. It contains lists of specific drugs to be aware of. It also includes some case studies and differential diagnosis information I think might be interesting and helpful.
If you find you are taking any medications or have any concerns about your medication regimen, I encourage you to talk to your physician promptly and discuss appropriate alternatives.
Related Topics: Study: SSRI Antidepressants Save Lives, Preventing Migraine Pain
Technorati Tags: migraine, SSRI, serotonin syndrome
There are times however, when a combination of drugs can be lethal if not watched carefully. In these situations, it is important for doctors to have a heightened awareness of these potential complications and avoid prescribing such combinations for their patients.
One condition that seems to be on the rise again is serotonin syndrome and it is seen most often in patients being treated for migraine headaches because of the combination of drugs involved. This syndrome is a result of too much serotonin in the body and it presents with a variety of symptoms that resemble neuroleptic malignant syndrome--a serious condition seen in patients taking neuroleptic drugs.
This article is very good as well. It has a bit more clinical information related recognition and management. It contains lists of specific drugs to be aware of. It also includes some case studies and differential diagnosis information I think might be interesting and helpful.
If you find you are taking any medications or have any concerns about your medication regimen, I encourage you to talk to your physician promptly and discuss appropriate alternatives.
Related Topics: Study: SSRI Antidepressants Save Lives, Preventing Migraine Pain
Technorati Tags: migraine, SSRI, serotonin syndrome
50 Comments:
thank you for this valuble information and please let us know more to it
I was told that I had serotonin syndrome after trying to quit taking Effexor "cold turkey".
My doctor wanted to prescrive effexor, I will let him know
I have migrane headaches! whew
I was just on the site after looking over some side effects from different medications that I'm on. I take Wellbutrin XL & Lexapro along with some meds for migraine headaches. This article concerns me greatly. Would this be something to bring up to the doctor or would they catch this on their own?
smiley31
I have been on Paxil for approx. 6 years and was taken to the ER once with confusion, rapid heartbeat, severe mood changes. The ER let me go with no diagnosis of serotonin syndrome. Also had similar difficulties when first going on the drug. Recently have been having similar problems when a doctor prescribed Trazadone for insomnia and increased my dosage of Paxil. She (most recent doctor) told me on the phone recently about serotonin syndrome. Can't believe this wasn't accurately diagnosed sooner.
to "smiley31"'s comment. DON'T wait for the doctors to "catch" it. I have been treated for fibromyalgia for about 2 years,with depression and aniety.My PCP Dr has prescribed Ultracett and have been taking for 2 yrs. My Physic Dr has prescribed effexor. over a short period of time My BP has increased enough to send me to the ER room a few times now. Headaches are occuring daily now and lethargy,confusion are just a few that have since increased. Recently prior to my Dr going on his vacation,refilled a prescription of the Ultracett(remeber,taking this for 2 yrs) was wriiten with the wrong miligram. Long story short, today they have diagnosised me with serotonin syndrom merley due to both my Dr's prescribing me medication that do not intereact and cause the addtional problems I have been having(ei,High BP,depression,sweats,confusion,aniexty,headaches) not only did NEITHER Dr "catch" this, niether has my pharmasist. Needleass to say, and greatly sad to say I have been negleted by ALL my medical providers inwhich I have to put my faith in treating me correctly. Now I am up against having to change over ALL my medications. and we all know how difficult of a transition that can be. PLEASE EVERYONE, research your own medications,research the adverse effects, combination drugs, ect. We can no longer just "trust" it will all be right.I have lost two jobs in the past 9 months,due to all my complication.
i am comong off lexipro down to 5 mg from 20...also i have been on meds for adult adhd....54 mg of concerta another 18 mg of concerta in late morning and 5 to 10 mg of ritalin in am and late afternoon....also i am on zomig when i get a migraine every two weeks or so...and i am on prometrium and vitelle dot as hormone meds for menopause. could this all add up to seratonan syndrome....please advise if you have any knowledge...thanks. sb
Last year it started around Thanksgiving. I was on two SSRI medications. I am bipolar as well as having fibromylagia and migraines. I didn't know about serotonin syndrome. I was in the hospital voluntarily because life had gotten very hard to deal with. I started having trouble walking. One day I had a seizure like event while there. The doctor did not stop my medication. Finally I was discharged on still on SSRI's. By Christmas I started having more seizure type events. I had to walk with a cane. My legs kept giving out. I was seen as "hysterical" when takne to the ER. Finally my regular psychiatrist realized what was going on. Took me off the SSRI's. I was so disturbed by the lack of support from the medical community that I almost did what the drugs were supposed to keep me from doing. Only knowing that I loved my family kept me safe. Now I am on the least medication I have been on in years and doing the best I have been in years. Serotonin syndrome for me was a nightmare. Recently I had a bad time when I lost a family member. I tried Wellbutrin again. Within a day I started having symptoms again. I called my doctor. He allowed me to stop it. I instead increased my therapy sessions. The important thing is to have a doctor you can trust and listens to you. I am fortunate. The doctor in the hospital did not. I know this is long but this was my experience. Good luck to those who have been there. You do recover but it is scary when you are there.
My doctor prescribed 80 mgs. of lexapro. I also take wellbutrin 300XL and ativan. Is 80 safe and does anybody know what the harmful effects are of taking such a high dose?
To anonymous above:
To post questions about your specific situation, please visit Indie's Pain Management message board. Thank you!
Is it safe to take effexor and phentermine at the same time?
My friend is taking lexapro for anxiey and was feeling depressed so she tooks some St. John's Wort. Results were nausea, vomiting, rapid heart rate. She only took one dose of St. John's wort and that was four days ago. The nausea is better but depression has worsened. How long before the interaction between the drug and supplement should end?
I have been having GI problems for the past three months and have been on Cymbalta for about 6 months or so and I have migraines really bad, and I had a spinal tap done showing pseudotumor cerebri. I wonder if the medication had anything to do with it. The article was very helpful.
I was switching from 75g effexor xr to 20mg fluoxetine three days agoand have had almost zero sleep due to Vivid Nightmares.
The switch was for cost of Rx but now I'm going to stop both and call to find out what to do. From what I read on this site the two meds should not cross paths and this seems what one effect of this Serotonin Syndrome is, the vivid disturbing nightmares,
I must agree that if you or someone you know suspects you may have serotonin syndrome, DON'T wait for a dr. to catch it!!!
My dear husband/pharmacist was the one who noticed I was "not right". I am a nurse -- and my co-workers actually let me drive home (shame on them!!!) after seeing my BP spike up to 200/120! When I got home, I was sweating profusely, shaking uncontrollably, confused, eyes twitching, etc. etc. I had been taking 150 mg Zoloft for Post Partum Depression -- and my OB/GYN did not catch it. It's just an illness that isn't seen as much -- but is now on the rise.
My husband spoke with my OB on my behalf -- explaining what all was happening. My doctor agreed that I was likely in serotonin crisis. I'm being weaned off the Zoloft and started on Wellbutrin instead.
I am very lucky to have someone who noticed I needed help and took matters into his own hands (my husband sought out a pharmacotherapist who specializes in psychotropic drugs -- and told him I was in trouble).
Serotonin syndrome is life-threatening -- DON'T WAIT to be diagnosed!!! Get help if you have the symptoms!
i am on 40 mg. of cymbalta have been on it for 3 months now, i have been having pain in the left side of my head and high blood pressure slso very dizzy and shakiness, just a overall feeling of not feeling good , and even the depression is still there, what should i do?
I have been on wellbutrin in a.m. and zoloft at night. I questioned my physician if people get "use" or "tolerant" of their anti depressant. She said they call it the SSRI slump and prescribed ritalin with the other two. I have had depression through out my life, but worsened with menopause.
Anyone hear of this and how did it work? I am also on HRT.
I am on 90 mg. of Cymbalta and it has kept me pretty stable except I still feel depressed. I am getting more headaches which I take verapamil XL 180 mg. 2 x a day, 2 mg. klonopin. I see my therapist every week and I feel like I am treading water. I helps me to talk but I need to have a plan when I feel depressed. The headaches are coming more often and I take butubital for them. Maybe it is time for a change in therapists. I don't know what action to take, but I do know I HATE feeling depressed when I am on an anti-depressant.
I read one comment on taking 40 mgs. of Cymbalta, and still having depression problems and more.. I am now on 30 mgs. and i have taken cyclobenzaprine for years and still do.., but i have trouble with mood swings, and tierd all the time especially when driving. This never used to be.... I wonder if other people are tierd all the time from cymbalta..
A combination of drugs - 4800 mg of neurontin a day, klonopin, zoloft, seroquel, ativan, zanaflex, ms contin, oxyir, roxicodone,) put me on the respirator. My family was called in to say their good-byes. My husband had to make the heart wrenching decision to turn off life support even though I had a living will. Thank God (and I mean that quite literally) I woke up that morning. I had been taking these drugs a long time. My husband felt something was not right but trusted my doctors as I was seen once a month. If your family thinks something is wrong. IT PROBABLY IS!!! Please, it is always better to be safe than sorry. Thank you for this opportunity to tell my story.
I am lucky to be alive. I went by rescue to the er on December 21st 2007 I went into respritory arrest almost as soon as I arrived was agaited confused and put in 4 point restraints I was intubated in the er and brought to the ICU I was on Zolfot and Vicodin and methodone for years of back pain from an auto accident I am bipolar. I was sent home December 24th for christmas eve ( I am jewish) I had been in a hospital room and out of the ICU for one day. I was let go with possibe serotonin syndrome. On Janury 4th 2008 I once again went by rescue to the er This time I was hypothurmic as well as confused etc.. also was pulling out my own lines Once again in the ICU intubated for 3 days and kept in the hospital for 3 weeks they felt the need to make sure of what it was well it was serotonin syndrome Please be ware of all meds you take and any symptoms of the seortonin syndrome do this for yourself and the hell this could put your family through
OH MY
Ive been reading this and I am in shock !
I take 225mg of Effexor, 200mg of Tegretol, 1800mg of Neurontin, 175mg of Elavil AND I use Imitrex nasal spray when I have a migraine!
After reading this I think I should go see my doctor TODAY !!!!
I was just diagnosed with seratonin symdrone. I take 20 mg of cymbalta and was having trouble sleepinp w/out any adivan. of the lowest dose. so my acupuncturist gave me some Blue Dragon herbs to sleep and I did sleep but had a very extreme reation to the combination and she knew I was on Cymbalta. My Dr. should have caught this and did not because he couldn't find time to see me by his staff. even when I was in crisis mode. They should have treated this as an emergency And instead not to priorize iteven though I was having deficulty breating.
I had never heard of serotonin syndrome until today when my doctor said it may not be a panic attack...it might be serotonin syndrome. I hope there is a way to determine which it is before I have another episode.
I take amitriptyline and verapamil daily,I also take a zomig/imitrex nasal spray and/or hydrocodone with very frequent migraines. Does this fall under seratonin problems? I have small children and I am a little worried. Any feedback appreciated.
I had been on Zoloft for about 4 months when various muscles in my body began jerking uncontrollably. It would happen when I was most relaxed. My leg, or foot or finger or wrist, etc. would flail out. I had no idea what was wrong; but, luckily, I read an article about seratonin syndrome. I went to the doctor and he began to wean me off of the Zoloft. I was not using it for migraines; it was not because of use with any other drug. Thankfully, after about a month without Zoloft, the jerking has just about stopped. Very scary.
I have suffered with migraines since I was 12 years old. Previously I was put on Pristiq for about three weeks during which time by cholestrol shot up to 1341.However once I was off the Pristiq for only 3 weeks my blood work was completely normal. I am know taking Effexor, Buspar, and Phentermine along with Topamax for migraine prevention. Should I be concerned?
Is it safe to take effexor and phentermine at the same time?
Informative article, thank you. I'm curious about the absorption rate of meds (I'm on 20 mg Lexapro XR) in one with Hepatitis C. I am between stages 1 and 2 as far as liver damage goes (fairly mild), but wonder if even that small amount of liver damage can affect how my antidepressant is assimilated. Thank you.
I wish I could get some phentermine for loosing weight.Darn military drs dont like to prescribe ANYTHING.But if you get heavy enough they'll give you the super expensive gastric bypass.Is that crazy or what? I didnt think you could take phentermine w/all those other drugs.People should really ask their drs not the others on here.Be careful!
auI NEVER HEARD OF SEROTONIN SYNDROME AND HAVE NO IDEA WHAT IT DOES TO YOU,BUT ALOT OFWIERD THINGS HAPPEN TO ME.I HAVE BEEN ON ANTIDEPPESIVES FOR 8 YEARS NOW.AFTER LOSING MY 2 SONS IN A CAR CRASH,AFTER THAT I LOST MY RANCH AND MY HORSES.I TAKE 20mg.PAXIL DAILY,4mg.ATIVAN,1 IN THE MORNING,3 AT NIGHT,30mg.DALMANE AT NIGHT.HAVE MIGRAINES 4 28 YEARS BUT INTHE PAST FEW YEARS THEY'VE BECOME ALMOST UNRESONSIVE 2 MY MEDS.FIOICET OR MIDRIN,HAVE DIFFERRENT TYPES OF MIGRAINES.THE MEDS.USED 4 YEARS IN THE ER.DIDN'T WORK 4 MY LAST MIGRAINE WHICH LASTED 12 DAYS.USING TORADOL,DECADRON,BENADRL,INJ.I'VE BEEN HAVING FAINTING SPELLS AND DIZZINESS AND FEELING JUST PLAIN WEIRD,SWEATING,UNEXPLAINABLE FEVER,ETC.FOR A COUPLE OF YEARS NOW .NOBODY CAN EXPLAIN IT.CAN ANYBODY HELP ME?ALSO STATE MEDICAL PLANS HERE IN PUERTO RICO ARE NOT GOOD AT ALL.I HAVEN'T BEEN ABLE TO GO BACK TO WORK BECAUSE I'M ALWAYS SICK WITH ONE THING OR ANOTHER.MY DR.SAYS THAT DEPRESSED PEOPLE HAVE A WEAKER IMUNE SYSTEM,BUT I HAVE BRONCHITIS ALMOST MONTHLY,ALONG WITH OTHER THINGS AND I DON'T HAVE AIDS OR ANYTHING LIKE THAT.I DON'T USE DRUGS OR ALCHOL,AND DON'T SMOKE.WHAT'S WRONG WITH ME?I ALSO HAVE MEMORY LOSS,ARTHRITIS,CHRONIC THROAT INFECTIONS,ULCERS THAT COME AND GO WITH TREATMENT.I WOULD LIKE TO STOP TAKING THE PYCIC DRUGS BUT THEY HAVE KILLER WITHDRAWAL SYMPTOMS.I TRIED,THOUGHT ABOUT DOING SOMETHING I DON'T BELIEVE IN.
.....My pharmacist just told me tonight not to be mixing Celexa and Ultram together on a regular basis which I have been doing. I had never heard of serotonin syndrome, but i know i have it. I have had dizzy spells, uncontrollable sweats,headaches, confusion, off balance, depressed, moody, uncontrollable crying. I haven't been myself. I am also on Methadone, but this has never bothered me until about 2 months after i got on methadone, and I was already on Celexa at the time. Then I just added Ultram to the picture about 2 weeks ago, and I have been going down hill from there. So do i just quit taking the celexa, or the ultram? I can't the methadone, but how do you treat this problem? What do doctors do for it? If you have any answers or insight for me pleasr let me know......
I FAINTED LAST FRIDAY,FIRST FELT DIZZY AND THEM EVERYTHING WENT BLANK.WHEN I CAME TO I WAS IN A WHEELCHAIR HEADING TOWARDS OBSERVASION.I WAS ALREADY AT MY DOCTORS.I WAS TOLD THAT MY BLOOD PRESSURE WAS 160/120 AND THAT MY SUGAR WAS VERY LOW.I DON'T HAVE PROBLEMS WITH EITHER ONE OF THE 2.COULD IT BE THAT SEROTONIN SYNDROME? THIS IS GETTING WEIRDER EVERYDAY.I NEED SOME INFO ABOUT THIS STAT!!!!!!!!!!!
I have Fibromyalgia and am taking some of these mixed meds as well. Can't sleep and have "panic attacks" mild mostly, sometimes not. I am assuming once the meds are corrected, the affects of the Seretonin Syndrome will be gone and I can sleep? This has never been brought up by my Doctors or pharmacists either.
I just returned from my first ever trip to the ER. I have been taking celexa for one week and was on the second day of increasing my dose. I also take darvacet for pain as needed. I took two darvocet, one at 4pm and one at 8pm then went to bed about 11pm I woke up feeling strange around 3am and was next woken up by my girlfriend in a panic. I felt like I was going to die. I saw myself in the mirror and I was pale and my pupils were dialated. It took about an hour for the symptoms to fade but we went immediately to the ER. I suspected my meds caused this but they did not mention it at all even after pointing out the combination I was taking. When I got home I read the side effects that came with them meds and found this article. My doctor that prescribed this combination said it would be fine also.
READ THE STUFF YOURSELF! This was very scary and I could have avoided the whole incident by reading first.
if im taking these two drugs can it cause severe neurological problems?? Imitrem and lexapro?? what can that do???
I have been taking 60 mg of Cymbalta for the last six months. Over this period of time, I have had increasingly vivid and disturbing dreams, so much so that I am being weaned off of it and being put on Pristiq. Has anyone suffered from bizzare dreams?
I'm 18 and have been suffering from chronic migraines for over a year now. The Migraines were ruining my life; I couldn't socialize , go to school (very upsetting as I am a distinguished student and will graduate at the top of my class), or even stand to be awake. So I went to the best neurologist practice in my home state. I began some treatments for the problem but it was very experimental and hit and miss. Due to my passion for academic endevor I was petrified and super stressed out when my school performance and attendance plummitted due to my migraines. The stress became so bad I begain having severe panic attacks. I then sout out a psychiatrist to help me with the issue. The doctor perscribed me Paxil 20mg, and over a three day period upped the dose to 50 mg and added stratera.(this was a very aggressive and pore decision as i am very thin and strongly affected by medicen). A couple of days later my family physician called my house and told me about a brand new migrain drug and asked my mom to come pick it up and try it. The new medicene was called TREXIMET. When my mom got to the doctor's office to pick up the medicen she told them that I was on Paxil and Stratera and she asked if the combination with these and Treximet would be okay. My mother was given no warnings or precautuions and assured my mother it would all be fine and that there was nothing to worry about it. So my mom came home that saturday evening and gave me one dose to start out. The next day (sunday) my mom gave me two more doses over a period of time and began going downhill. My eyes dialated , I began sweating profusely while sitting down doing nothing, my vision was affected and I thought things in the room were moving (and other hallucenations) my whole body became stiff and rigid (mainly my muscles, and my left arm begain convulsing. My mother new something was wrong and my parents took me to the ER. Upon Arrival at theER the Er doctor told my parents that nothing was wrong with me and that i was just being dramatic and faking while running to tests for drug interactions. The doctor then discharged me, and my parents took me home.At this point my body is very rigid my teeth are gringding and I am begging to get worse and worse. On monday morning about 5am (i was unreesponsive at this point) my mother found me in a catatonic state and new the situatuion was dire. My family told me later that i was carried out of the house to the car as stiff as a board.Upon arrival at the ER the second time a new doctor began to run manyh tests , even a spinal tap. The doctor being fairly experienced came to the idea that I had Seratonin Crisis. I was getting worse and began to die. The medical staff was doing stuff to pump the drugs out of my system. Had i not gotten to the ER a when I did I could have been dead in a matter of hours or even a few more minitues. It was really serious and I almost didn't make ti. My family and I are thus really pissed at the doctor that gave me the Treximet and never warned me of any potentially dangerous drug interactions,and we are also really pissed at the ER doctor who saw me the first tiime and said I was faking it and bein dramatic and sent me home. The negligence of these two doctors almost cost me my life. Anyway, I woke up on Tuesday morning in ICU and had no clue were I was , my condition was really touch and go. The recovery proccess has been complete HELL. I have suffered so much. The incedent caused me severe muscle damage in my legs,back,arms and about everywhere else and I can barely walk. I have had to go through agonizing rehabilitation and have had to take heavy painkillers and muscle relaxers almost constantly. It hasdestoyed my social life, I havent hung out with friend , gone to church or anywhere for months except rehab. Even worse is the psychological stress it has put on me. because this took place during my fall semester of my Senior year , and the condition caused me to miss school and my straight A's plumet my guidence counselor told me that I needed to take theyear to recover and try to do my Senior year next year. I was so sad and deppressed as I was going to graduate top of my class of 400 and go to an Ivy League school and I had tons of huge scholarships waiting for me! I hope no one EVER EVER EVER has to go through this to due a lack of vigilence or negligence.ny one whoe hase experienced Seratonin Syndrome please post me a comment! Also I am considering a Medical Malpractice suit if any one has any good advice or knows a good law firm that is specialized in this kind of thing please post me about it. IF YOU EVEN ROMOTELY THINK THAT YOU MAY BE AT RISK FOR OR HAVE HAD SERATONIN SYNDROME PLEASE TALK TO YOUR DOCTOR AND A WELL QUALIFIED PHARMACIST JUST TO BE SAFE IT COULD SAVE YOU A LOT OF PAIN< THOUSANDS OF DOLLARS IN MEDICAL TREATMENT OR EVEN YOUR LIFE!!!!!!!!!!!!!!!!!!!!!!!!
bI take Cymbalta for depression, anxiety, obsessive compulsive disorder and constant worrying. However, About ten years ago, I was first put on Zoloft. After several years the Zoloft didn't seem to work, and after telling my family physician, I was put on Lexapro. Later, Lexapro seemed to stop working. Thus, I was put on Cymbalta. Cymbalta works well. However, it seemed to me, it made me too layed back and I just could not make myself concentrate. I told my M.D. I felt like I was ADD because I could not remember or concentrate and I could care less about cleaning the house, getting to work or anything that is a normal concern for what I think a normal person would consider important. I now take Vyvanse in conjunction with Cymbalta. I feel much better. I can play the piano, which after ten years of lessons before the meds was a struggle because I couldn't focus because of worrying and getting distracted by the worry. However, I am concerned because I seem to be hyper focused on whatever interests me at any given time. For instance, I can practice the piano for hours at one sitting or study the Bible for days. At this moment, I am completely submerged in learning how to use the computer. I would have never typed something like this before, because I would either be worried about the consequence, obsessed on getting every detail right or paranoid about the security issues of the internet. Alas, the Vyvanse causes me to be acutely focused on whatever crosses my mind, leaving me awake for hours passed my bed time. I am a traditional Southern Baptist Christian, raised by very loving parents, married to a wonderful man with whom I have a normal 15 year old son. We have a nice 3,000 square foot house with five dogs and a cat. I have no reason to blame anyone for my problems. I own a successful business. I graduated with honors from a four year college and have a Master of Cosmetology license. If I could find one thing to blame my psychological funk on, I would. I can't. Somebody help me! I Have everything. I love God, I love my family and I love myself. I just cannot seem to get out of this fog of misery. By the way, when I finally decided, at the age of 35, to talk with my doctor about my sadness, I couldn't believe the depth of the origins of my psychological state. The doctor asked me, "How long have you felt like this?" I responded," I have felt this way since my first memory of existence." Doc put me on Zoloft and told me it would take a few weeks to see a difference. I beg to differ. After only a few days, I noticed an unfamiliar smile on my face, a relaxed brow, an awareness of the beauty in nature surrounding me, and for the first time in my life, I DID NOT FEEL LIKE EVERY BAD THING IN THE UNIVERSE WAS MY FAULT!!! It was like a person with bad eyesight given a pair of prescription glasses. However, somewhere deep inside me is the fear of the gray place. Is it okay for me to combine Cymbalta and Vyvanse?
I found out the combination of drugs I am taking cause Serotonin Syndrome. I took a list of the ones that are major to my DR. he ignored my concern and told me that I didn't have it although I do have the symptoms. I am so confused about this. I have been on effexor for over 10 yrs+. Anyone know what can I do?
I am on disability for generalized anxiety disorder with panic attack. For the past year and a half I started taking paxil 20mg once a day; ativan 2mg twice a day, and remeron 35 mg at bedtime. Because of the anxiety disorder I've been hospitalized about once a month during that time. Every time I saw the pysch.Dr. he was able to see through his computer system that I was in the hospital for uncontrollable vomiting and because my body was in so much stress my wbc shot up to 24,000. normal is 9,000. Anyways long story short gradually he increased my paxil to 80mg in the morning, ativian 2mg twice a day and remeron 45mg at night. In Feb. 2009 I had a seizure at best buy, I lost concessness and my husband thank god was with me, he said I put my hand over my head and said "Babe I don't feel good", suddenly I pulled out my left arm and it was shaking perfusly I remember that, but what happened after that I don't remember. He said I feel back and he caught my fall with my sweater, also during the seizure I was bitting down on my tongue. When the ambulance arrived he said they were asking me alot of questions like "whats my name, what city do I live in" simple questions", and of course I did not know any of the answers. I don't remember any of that, all I remember is looking at t.v's and ending up in the back of the ambulance. When I got to the hospital the doctors said they were not sure why I had a seizure because the CT Scan was normal, there theary was that many people have seizures once in there life and never happen again, and some people will continue to have seizures, so I left the hospital clueless not knowing what my life was going to be like. A few days later I had an appointment with the pysch. Dr. and I told him what happened, I asked him if he thought it was due to my medications that he had me on, he assured me more than likely no, and gave me knew prescriptions. That week my husband told me I was having seizures in my sleep, were my head,left arm and left leg went up from the bed and went back down, he did not want to wake me because he said I went back to snoring. He just watched over me. The next morning he notified me of what happened, but I was going to put off going back to the hospital because that weekend was my daughter 8th birthday, and of course that did not fly by my husband, because I shaking he wanted me to go. So Thursday night he drove me to the ER and of course I did not get called back until 5am Friday, even though I was experiencing partical seizures in the waiting room, it still took that long. When I got to the back my pulse rate was setting off the machines to where the nurse thought the machine was bad, so she switched it to another machine, and of course it kept going off. When the Neurology Dr. came in he started doing a physical on me and he noticed my reflexes were positive, to excessive, about a few minutes a team of neurologist came to my bed side and started another physical. They made me touch my nose with my eyes closed with my left hand and I did it perfectly. Then they told me to touch my nose with my eyes closed with my right hand and I kept missing my nose. Through out all that time where my pulse was high, trouble breathing. I was sweating profusely, and I asked the nurse is it hot in here, she said no its very cold, I felt like I was on a treadmill and it would not stop. The neurologist then asked me what meds was I on and how long have I been on them when I told her, real quick she said " check her serotonin level" after that they admitted me in the hospital, they took me off all my medications and started me on Clonazepam 1mg at bedtime, they said it was much safer and it will help with panic attacks and seizures. My discarge report states diagnosis: Serotonin Syndrome. I have been out of the hospital since March 1, 2009 and know since they took me off all my medications, I am very emotional, still shake, I don't sleep if any about 4 hours and then I wake up anxious. I wet the bed sweating for about a week afterwards. During my stay in the hospital the CT and MRI Scan of the brain are normal, now I am awaiting a EEG on March 24, 2009. I am 28 years old and since I was 15 yrs old I've been in and out of the hospital due to uncontrollable vomiting, I've had an Upper GI, Lower GI, endoscopy, colonoscopy and every test normal, you name it and I probably had it, I think the EEG is the last test, and If thats normal, I'm fine right. So my plan is to start going to bible study as therapy for me, I started going back to church. I am going to start an exercise regimen, I have a treadmill thats been collecting dust so my husband took it out of the storage for me. Hopefully I will get my serotonin naturally by exerising, but of course the doctors told me some people still don't get it, even though they exercise. I am so tired of medications that I plan to wing myself off clonazepam eventually. The day after I was released from the hospital I did not have headaches anymore, and the Dr. put me on a migraine medication when I was released that sunday, they said it take about a month before I would see any changes in my headaches. I took it sunday night, monday morning when I awoke I did not have a headache so I discontinued my migraine med. I believed that my headaches that would not go away were because of all the medications I was on. I feel okay, I don't have headaches, but of course I don't sleep at night, and I battle with anxiety, panic attacks, and depression everyday, know I can't rely on medications, but thats okay I could of died due to the seizures or the Serotonin Syndrome so trust me I do not want to take any medications anymore. Know I give it all to God and enjoy every waking moment of my life with my daughter and husband.
My husband died from Serotonin Syndrome on Jan 17, 2009. He was on Geodon, Anafranil, Depakote, and Cogentin. He broke his ankle in 5 places on Sunday. Was given Fentanyl at the hospital and percoset while awaiting surgery on Friday and discharged home. The codiene triggered the syndrome. It was missed when I took him to the ER on Weds for increased tremors and clonus activity and pretty "out to lunch". They thought it was just a bad codiene reaction---and to stop the percocet. Friday when we got him in for the surgery he was still out to lunch but better than he had been. The ortho wouldn't operate and sent us to the ER. I told ER doc I thought it might be Serotonin Syndrome--but codiene is not a recognized med trigger... they treated him with anti-psychotics, benzo, and depakote...and long story short my husband spiked a 107.8 degree fever, after convulsing for hours (not responding to the high doses of Ativan being pumped in to him). The fever and rhamdolysis (sorry spelling may be wrong) killed him in the end. Now I am without my wonderful husband because of this.... it is just sooo wrong. and this syndrome has to be better recognized by the doctors!!
I tried effexor about 8 years ago and it made my anxiety worse so I dealt with it for about another 3 years after I had my daughter before I tried another medication. I was then put on zoloft and eventually was on 150mg I stopped taking it because of the side effects. I started back on it and ended up on 100mg and I couldn't stand the side effects so I stopped taking it cold turkey. I dealt without any medication for a year before I couldnt take the anxiety attacks anymore and was just recently put on a generic prozac is it ok to drink while I am taking it. I just started it on monday and it is only thursday
My story is on march 17, 2009, after reading everyone response especially dealth, we need to stop this, so if any one has a lawyer for malpractice lawsuit, make it available. I sent my story to texas malpractice lawyers but they have not responded.
I currently am taking 20mg of Lexapro at night before bed, and have been for years.My orthopedic doctor gave me a perscription for Tramadol 50mg. 3x's a day for the pain in my hands. I have only been taking it for a week, and it has been hell. I wake up sveral times a night with a migraine, confused, sweating, nauseas, with my blood pressure way up. I believe this could be serotonin syndrome. I've decide I'm going to call the pharmacy and doctor on Monday, and stop taking the tramadol. The day after these wicked nights I feel like I can't hold two thoughts together with super glue, or make a decision to save my butt, I have time periods that I can't remember anything. This is scarey.
I am 28 and have been on Paxil for approximately 14 years for general anxiety disorder and have had very minimal side effects; however, in April of 2008 I had the worst pain in my upper abdomen area, which was so severe that it left me bed ridden for a few months. The pain was followed by nausea, loose bowels, increased heart rate, and constant sweating. After having an upper GI performed on my doctors found that my stomach just seemed inflamed and said that there was nothing to worry about. I continued on most of the summer and the symptoms seemed to slightly go away over time. I noticed as time progressed that I began to feel as though I was hypoglycemic, because I felt extremely weak and shaky if I did not constantly eat or have something in my stomach. Life was pretty uncomfortable for the remainder of the year, but on December 17, 2008 I had the most intense severe anxiety attack of my life. I was taken to the ER after my a few hours of taking Xanax, because the attacks were not lessening, and Xanax had ALWAYS worked before. I knew there was something terribly wrong. My blood pressure sky rocketed to dangerous levels and I had intense vertigo, tremors, sweating, confusion, and I was VERY cold. They ran all sorts of tests on me but found everything to be in order.
The ER doctor looked me over and provided me with Lorazapam, because he thought that my Xanax just may not be doing it for me anymore. In addition, he placed me on blood pressure medication to help control my blood pressure as well as tremors. I was advised to continue taking my medications as normal even though I was insistent that something was DEFINITELY WRONG with Paxil. The ER released me as soon as my vitals were down to a normal level
At that time my Psychiatrist was out of town enjoying the holidays. I continued to take Paxil as directed, because the doctor always knows best right? Well my symptoms continued on for an additional two weeks, until I was able to see my Psychiatrist after he got back from vacation. He advised me that I may have suffered from Serotonin Syndrome and that I needed to get off Paxil immediately. The next four months were very intense because of the severe sickness that I went through. I lost my job and I was not able to leave my house, because the withdraw side effects and Serotonin Syndrome symptoms were too intense. I was rushed to the ER on five separate occasions, because I began to have SEVERE tremors to where it looked like I was convulsing. I basically suffered from every side effect that could have been listed except for seizures, thank God! Six months later I am a fully off of Paxil and I am lucky to be alive!!! I have lost MOST of my faith in the medical field, because most doctors to do not have any idea on what Serotonin Syndrome is. I still suffer from constant anxiety, but I am attempting to cope with it and find a way to heal naturally.
I would appreciate any feedback on my situation. I recently upped my Paxil from 20 to 40mg. I've been on this for 15 years. I now have high blood pressure 150/100 which I never had.and my anxiety attacks are back. The drug was first for depression and anxiety. And is Paxil itself no longer produced? I'm now on paroxetine HCL
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I had been taking Phentermine for about 6 months and was prescribed Zoloft for depression and mild anxiety. I had taken Zoloft in the past and it worked great. 2 weeks later I started experiencing tremors, confusion, sweating, hot flashes, tachycardia, diarrhea and a general lack of muscle control. My doctor said that the problem was Serotonin Syndrome and that the Zoloft and Phentermine shouldn't be taken together even though she prescribed it. I immediately stopped Phentermine but still had same symptoms a week later. Doctor stopped the Zoloft too. Finally the symptoms subsided for the most part except for some shaking and sweating. I started back on Zoloft and was ok for about 2 days before the tremors, tachycardia, sweating, and headache started full force again. I have again stopped Zoloft and am just waiting and hoping that symptoms will disappear.
I have a question...I am on wellbutrin and just started taking methadone also! Can these two drugs be taken at the same time?
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