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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by BRC on June 27, 2004, at 13:35:02
Hi, I read the earlier post about Serotonin Syndrome. I was aware of the condition but did not know all the symptoms.
I take 40mg Lexapro and 30mg Remeron. I daily experience symptoms such as tingling senations, muscle spasms, my hands tremble, and when I go to raise my legs (like in bed) or raise up my limbs tremble. I thought these where all symptoms of my anxiety disorder and side effects from the meds.
But could this be Serotonin Syndrome. I know this is not a place to diagnos anyone. But is this something I should discuss with my doctor soon or can it wait?
Anyone's comments would greatly be appreciated. Thanks in advance.
Posted by 1980Monroe on June 27, 2004, at 14:37:25
In reply to Could Remeron and Lexapro cause Serotonin Syndrome, posted by BRC on June 27, 2004, at 13:35:02
I do not belive these two anti-depressants combined can produce serotonin syndrome.
But here are definant signs of it just in case
The symptoms of the serotonin syndrome can include, but are not limited to:
: Euphoric feelings
*
Drowsiness / Tiredness
*
Sustained rapid eye movement
*
Overreaction of the reflexes
*
Rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot
*
Clumsiness
*
Restlessness
*
Feelings of being drunk or dizzy
*
Muscle contraction and relaxation in the jaw
*
Sweating
*
Intoxication
*
Twitching of the muscles
*
Rigidity
*
High body temperature
*
Mental status changesBe sure not to take 5-HTP supplements, since being the precursor of serotonin which raises levels also, but i think you would have told that already.
These combinations are known to causes serotonin syndrome listed below, but i dont belive lexapro is listed below on generic terms
* paroxetine plus dextromethorphan and pseudoephedrine
* paroxetine plus nefazodone
* fluoxetine plus clomipramine and buspirone
* fluvoxamine plus buspirone
* fluoxetine plus buspirone
* amitriptyline plus meperidine and venlafaxine
* venlafaxine and dextroamphetamine
* fluoxetine plus clomipramineIll look up some more just in case
Posted by utopizen on June 27, 2004, at 16:44:15
In reply to Could Remeron and Lexapro cause Serotonin Syndrome, posted by BRC on June 27, 2004, at 13:35:02
> Hi, I read the earlier post about Serotonin Syndrome. I was aware of the condition but did not know all the symptoms.
>
> I take 40mg Lexapro and 30mg Remeron. I daily experience symptoms such as tingling senations, muscle spasms, my hands tremble, and when I go to raise my legs (like in bed) or raise up my limbs tremble. I thought these where all symptoms of my anxiety disorder and side effects from the meds.
>It could just be that one of the meds is too much for your body. 15mg of Remeron typically helps many people, and I'm not sure whether it's proven if 30 or 45mg offers statically more response over placebo. Maybe someone in here knows? I read an abstract recently on Medline that established highest dose needed to find response for antipsychotics. Abilify was rated at 10mg, and I take 30mg currently.
SWEATING, AGITATION AND TREMOR are, I believe if I read my Zoloft side effects warnings correctly, symptoms associated with toxicity. But that's with any drug when you have these symptoms. If you're sweating at all in your hands or face or so that's toxicity often. Agitation is pretty severe, and it sounds like you have it. Rigidity or restlessness alone is ussually associated with antipsychotics... I'm not sure if you have that, but talk to your doctor. TREMOR is a pretty big side effect when it comes to your body warning you.
Muscle shocks are NOT associated with anxiety-- talk to your doctor about this, and possibly a neurologist who would likely order a EEG test. I've only heard of it being associated with withdrawl.
You may find these could go away if you, say, go down to 20mg of Lexapro and 15mg of Remeron, all common and effective doses as much as the ones you're on now. And then if you still find difficulty you can always cut one off or switch to a different med.
But talk to your doctor about it all. And you should be telling your doc about these side effects, not to sound nagging... but they are listed under the side effects section that read "talk to your doctor immediately" section if I'm not mistaken.
Posted by BRC on June 27, 2004, at 19:33:06
In reply to Re: here's some helpful info, posted by 1980Monroe on June 27, 2004, at 14:37:25
Hi, this is BRC the origninator of the post. I want to thank you soooo much for all the information you provided in your post.
I do suffer from alot of the physical symptoms you listed. But I do not have any of the mental sings such as euphoria, feeling drunk, sweating etc. But I do tremble and tingle and my muscles have began to twitch and spasm all over.
I am only 28. Been checked out by a thousand docs and had every test known to modern science done, so I am confident it is nothing biologically related. I think it is either the medication or my anxiety. Because I am very restless and unable to sit still. I really don't know what to think.
Thanks for your concern. Hope to hear from you soon.
Posted by BRC on June 27, 2004, at 19:55:16
In reply to Re: Could Remeron and Lexapro cause Serotonin Syndrome, posted by utopizen on June 27, 2004, at 16:44:15
Hi, thanks for your time and concern by answering my post. I currently see a neurologist and a pdoc. I have had several EEG's, nereve conduction studies, and a host of MRI's. This is all because of a benign vascular tumor in my spinal cord. But the only effect the tumor has is it is pressing against some nerves in my spine that cause my left leg to hurt and a moderate case of muscle atrophy.
I take 40mg of the Lexapro because I have OCD and all the docs tell me it takes a higher dose of an SSRI to treat OCD. The Remeron is mainly a sleep aid.
But the tremors are getting very bad. They are almost embarassing. Because I will be holding a glass or handing someone a piece of paper and I am shaking so much. I know they probably think I am on some illegal drug or something. And the muscle spasms occur when I am trying to rest or setting still. Parts of my body will just go to twitching. And the tingling sensation is a hurtful one. That Radiates througout the body.
Sorry for rambling on. But I think all of the symptoms has to do with the medications actions on my central nervous system.
I am a 28 year old male weigh approx. 160lbs don't drink and have never used drugs. I exercise daily. But I do not really know what is causing the symptoms. If it is the medication then I don't know which is worse depression, OCD, or the physical symptoms.
Anyway thanks for your input and concern. Hope to hear from you soon.
Posted by 1980Monroe on June 27, 2004, at 20:18:13
In reply to Re: To 1980Monroe » 1980Monroe, posted by BRC on June 27, 2004, at 19:33:06
Your absolutely welcome, anyways, as you said your still having anxiety, ask your doctor about ativan, or valium, valium has some muscle relaxant properities and mild sedative too, which i think would be the best in your case.
Now if your figity because you just feel the urge to surge, your may have ADHD, but thats not really a direct suggestion, if its mistaken for someting else, Stimulants may aggrevate your twiching. Soma could be a good med, for the muscle spasms also.
Wish the best.....
Matt
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