Posted by Sunnely on August 17, 2001, at 23:57:11
In reply to How serious is serotonin syndrome, posted by PaulB on August 16, 2001, at 14:29:32
> I guess I had what you might call a serotonin syndrome when I first tried 5-HTP a few weeks ago. I was real sick, teeth non-stop chattering, hypomanic.
Serotonin syndrome usually occurs when a serotonergic drug is added to another serotonergic drug (can also occur with use of a serotonergic drug alone). It usually occurs within minutes to hours after a second agent is added. It is usually mild and resolves within hours after the offending drugs are discontinued. However serious complications such as severe hyperthermia, seizures, respiratory failure and even death have been reported.
The clinical picture of serotonin syndrome may present as mental status changes such as confusion, agitation, and hypomania. This is usually accompanied by other symptoms such as uncontrollable shivering or teeth-chattering, hyperreflexia, involuntary leg jerkiness or myoclonus, incoordination, restlessness, fever, sweating, diarrhea.
Some of the culprit combinations include:
MAOI + SRIs (serotonin-enhancing antidepressants)
MAOI + Meperidine (Demerol)
MAOI + Dextromethorphan (Robitussin DM)
Tryptophan + SSRI
Trazodone + SSRI
St. John's Wort + SSRIs
"Ecstasy" Intoxication (and deaths) resembles features of serotonin syndrome
Theoretically, 5HTP or SAMe + SSRIsTreatment:
1. Avoidance. If possible, avoid combination of serotonergic drugs. Use cautiously if clinically indicated. Observe washout period strictly from MAOI to SRIs and vice versa. Note: Prozac has very long half-life and therefore, requires much longer washout period than the others.
2. If suspected, stop the offending drugs immediately.
3. Symptomatic treatment if needed, such as: cooling blanket for hyperthermia, IM chlorpromazine for fever, anticonvulsants for seizures, clonazepam (Klonopin) for myoclonus, nifedipine (Procardia) for high blood pressure.
4. The use of a serotonin blocker such as cyproheptadine (Periactin) at 4 mg by mouth, may be repeated in 30 minutes also helps.
poster:Sunnely
thread:75302
URL: http://www.dr-bob.org/babble/20010814/msgs/75471.html