Posted by SLS on March 15, 2002, at 19:26:14
In reply to SLS: re Serotonin syndrome, more: » SLS, posted by Janelle on March 15, 2002, at 17:13:40
Hi Janelle.
Thanks for your concern.
> First, the reason that you had such a bad reaction when you took a very small dose of Effexor - less than 20mg - while you were taking Parnate (an MAOI) is because there are warnings all over the place NOT to mix SSRI's with MAOI's.
There exist similar warnings all over the place not to mix MAOIs with any other antidepressant or stimulant. You can - quite safely. You will find recommendations regarding these combinations in Dr. Bob's Tips. I have taken Nardil with amitriptyline and desipramine. I have also taken Parnate (150mg) with imipramine and desipramine. To the latter, my doctor added on top of that amphetamine (Dexedrine) and bromocriptine (Parlodel).
> I imagine the dilirious stupor you wound up in where you were confused and babbling nonsense was because apparently SSRI's and MAOI's do not mix! I have read all over the place not to take them together and also if you're going to switch from one to the other you should wait 14 days before making the change.
All I can say is that desperation can greatly influence one's decision-making process.
> As for the sorts of things I experienced that brought me to the conclusion that I had gotten serotonin-syndrome from the high dose of Luvox plus a moderate dose of EffexorXR well it's a blur now (my memory is shot thanks to the depression condition and I think the meds too),
I know the feeling.
> but I recall that I had the shakes and tremors big time, headaches, my head also *jiggled* inside. It was mostly the shakiness and feeling over stimulated, an overly caffeinated type feeling. I almost felt like I was on a high. It was my sister who first thought it could be too much serotonin and then when I had a visit with the pdoc she immediately said it was probably SS after I described my symptoms. That was what made her decide to titrate me down on the Luvox and lo and behold the symptoms went away. That this happened also led us to conclude it had to be SS.
Thanks for responding. SS seems to look different from individual to individual. I was curious as to how it was expressed in your case in order to get a better idea of what to look out for.
> I'm encouraged to that you mentioned that Effexor does not seem to "poop-out" nearly as often the SSRIs do because I am still very bummed out that Paxil which had worked wonders for me suddenly pooped out and I've not been able to stabilize since then yet.
I'll probably have to discontinue Effexor for lack of efficacy, but the results of a recent multi-center study of over 2000 cases compared Effexor to various SSRIs. The results demonstrated that Effexor got more people well and got each person weller than the SSRIs.
Other studies have yielded similar results.
> take care
> -JanelleYou too.
- Scott
poster:SLS
thread:97900
URL: http://www.dr-bob.org/babble/20020313/msgs/98217.html