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Re: Two questions about Serotonin syndrome. » schleprock

Posted by ChicagoKat on September 20, 2012, at 15:22:20

In reply to Two questions about Serotonin syndrome., posted by schleprock on September 19, 2012, at 21:44:22

> 1. Has anyone here actually had it. What are the most common symptoms that one can know are unmistakebly SS related and not side-effects or an exacerbation of mental illness. And most importantly, what do you do when you know you have it? Go straight to the ER or merely self-unmedicate the offending medicine.
>
> 2. Does SS occur exclusively from the mixture of more than one serotonin-acting drug, or is it possible to experience it from a particular dose (or overdose) of a single drug? In regards to the former situation, is it possible that the combination of two drugs that have a weak effect on serotonin could result in SS.
>
> Thank you, and stay well.

1. I've had SS...dumb me, I was on Prozac and had a cold and downed cough medicine with Dextromethorphan in it like it was no big deal. Boy did I pay...several hours later, I just could not sit still, had twitching, and then, worst of all had an unbelievably bad headache that was so bad it made me vomit over and over. had a high fever. Checked my BP and it was high, but labile. Went to the ER and they were clueless...if you can believe this, they gave me Zofran for my nausea and Demerol for my headache. The worst possible things they could have given me. Fortunately, my symptoms had subsided enough by then that I was OK. Didn't figure it out til later that it was SS, dumb pharmacist that I was. :(

2. SS can be caused by just one agent, though more commonly with two serotonergic agents. It's unpredictable in a way, except for obvious things like MAOIs and an SSRI. It all varies according to the drugs, the dosages, and the interidividual biochemistries of the patients.

I'm lucky; I once had a pdoc who prescribed chorpromazine for me (for my depression lol) but I hang onto it in case I ever have SS again, as it is an antidote.

I wish you the best,
Kat


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