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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by honeybee on March 3, 2006, at 15:02:56
Just curious. Not having it right now. Realize that in the past I may have experienced it.
Any thoughts?
hb
Posted by honeybee on March 3, 2006, at 15:05:32
In reply to Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 15:02:56
I guess to follow up to my just-post: Does it fry the serotonin receptors ("permanent" structural damage)? Or is it "simply" a toxicity reaction that, once cleared out of the system, is no longer a problem, so to speak.
Sheesh! Clearly showing I don't quite understand how the human body works... But curious, nonetheless.
Thanks,
hb
Posted by SLS on March 3, 2006, at 15:12:53
In reply to Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 15:02:56
> Just curious. Not having it right now. Realize that in the past I may have experienced it.
>
> Any thoughts?
>
> hb
Hi.I'm not an expert by any means. However, it is my guess that no brain damage occurs unless there is severe hyperpyrexia (high body temperature/fever).
- Scott
Posted by honeybee on March 3, 2006, at 15:33:32
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 3, 2006, at 15:12:53
Scott,
You're my latest good luck fairy. I could kiss you!
Now, no one else is allowed to respond, so I can at least pretend that that's the case.
(I mean, my suspicion is that the annoying glue-i-ness to my thought processes is the depression, not brain damage. But I'm one of those worriers.)
Posted by linkadge on March 3, 2006, at 15:55:37
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 15:33:32
I think that it could well be indicitive of brain dammage. Ecstacy can cause brain dammage without presenting any indication.
The serotonin receptors are being overloaded. I think it is certianly possable.
Linkadge
Posted by honeybee on March 3, 2006, at 15:59:06
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 3, 2006, at 15:12:53
Thanks, Linkadge. Way to make my day.
Seriously, though, it would make sense. But how would one know? And is it specifically a problem of overload on the receptors in the brain or is it a systemic overload (getting at the receptors in the gut and elsewhere)?
Posted by linkadge on March 3, 2006, at 16:16:36
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 15:59:06
Its hard to say. I know that I have had some significant mood problems after having serotonin syndrome. Think of it this way, Ecstacy can dammage serotonin receptors even before producing serotonin syndrome. Admittedly, the mechanisms may be different, but its certainly a possability.
Linkadge
Posted by honeybee on March 3, 2006, at 16:31:49
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by linkadge on March 3, 2006, at 16:16:36
Yeah, but I thought that Ecstacy caused severe depletion of serotonin... no? Must be confused on this one...
To be blunt, I used to drink while I was on effexor and I seem to recall, perhaps fautily, that alcohol does boost serotonin levels in the brain. I weigh about a buck o nine, and it wasn't smart of me, but I pretended that there wasn't a problem with it. Effexor *always* caused night sweats for me and overheating at night, especially so when I'd been drinking. It played with my hormones, as well, so it was never clear to me whether or not this was some sort of serotonin syndrome [a term I only found out about years after I'd gone on effexor--thanks pdoc!] or just a pleasant side effect of the drug that was amplified when my body couldn't assimilate the effexor as quickly because of the logjam created by the alcohol. A puzzle indeed. And, of course, my most recent pdoc, when I inquired, pooh-poohed my concern.
What was serotonin syndrome like for you? From the way it's described, it's a terrifying, bone-chattering mess of sweat and terror (or jubilation). Again, having been asleep for my instances of potential serotonin syndrome, I have no recollection of anything but occasional drenched mornings and nights during which I sometimes remember being alternately really hot and really cold.
Posted by Squiggles on March 3, 2006, at 17:08:42
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 3, 2006, at 15:12:53
> > Just curious. Not having it right now. Realize that in the past I may have experienced it.
> >
> > Any thoughts?
> >
> > hb
>
>
> Hi.
>
> I'm not an expert by any means. However, it is my guess that no brain damage occurs unless there is severe hyperpyrexia (high body temperature/fever).
>
>
> - Scott
I keep thinking i had a stroke and seizure
when i was w/d from K, but it could have
been serotonin syndrome; i had severe sweats
and i guess hyperpyrexia which make have
evoked a seizure and stroke, maybe in the heat
an actual heat stroke. Heat is common in
w/d.Still don't know what happened; a nurse
told me i should have seen a neurologist,
a n--e--u--r--o--l--o--g--i--s--t and she
glared at me while putting on the electric
curlers, lol.But yeah, i think after that something happened
to me. Strange thing is -- by sheer serendipity
when i had an accidental concussion this summer
my brain switched to another mode - some
of the damage like head heat, extreme lithium
toxicity "FEELING" and appetite have changed.
I seem to be better.I'm *ucking indestructible. :-)
Squiggles
Posted by Racer on March 3, 2006, at 17:52:06
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 16:31:49
>
> And, of course, my most recent pdoc, when I inquired, pooh-poohed my concern.
>I have no answers for you, but I hate it when doctors do that. I asked a doctor something, forget what, but the answer was a curt, "You don't have it." Hello? I'm asking for information, not because I think I have it.
The end result, for me, is that I am so very careful when asking a doctor anything, that I sound INSANE! "Doctor, I know this isn't any sort of problem, and I realize that there are many benign causes, and I wonder if you'd take a look at this rash?" Sheesh. And, honestly, most of the time I don't even bother to ask...
(My question might have been about Cushing's syndrome, when I asked the doctor, now that I think of it. She finally asked why I'd asked -- "I know someone who has it, and wanted to learn more" -- at which point she was generous enough to answer...)
Sorry to break in.
Posted by linkadge on March 3, 2006, at 20:56:28
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 16:31:49
Serotonin syndrome is a continuom, I believe.
I had mild SS on SSRI's but it was deifnate when I did dumb things like combine SSRI's, SJW 5-htp etc.
Linkadge
Posted by Phillipa on March 3, 2006, at 21:50:44
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by linkadge on March 3, 2006, at 20:56:28
Just a thought but could the night sweats and cold be caused by going through menopause. Don't know age or sex. Just a thought. Fondly, Phillipa
Posted by Squiggles on March 4, 2006, at 6:29:47
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by Phillipa on March 3, 2006, at 21:50:44
> Just a thought but could the night sweats and cold be caused by going through menopause. Don't know age or sex. Just a thought. Fondly, Phillipa
I'm not sure if this question is directed to me;
if so, the answer is no. It was in the process
of withdrawal that this happened and my dr. said
it was clonazepam withdrawal. I had to go back
to a higher dose just to save my head. I never
really felt great after that, but i had to take
the drug. It was a "thunderclap" "stroke, seizure?" and i was sick after it - in bed for a month and a half.Squiggles
Posted by SLS on March 4, 2006, at 7:46:49
In reply to Does Serotonin Syndrome Cause Brain Damage?, posted by honeybee on March 3, 2006, at 15:02:56
Short of hyperpyrexia, seizure, and stroke, I would have a hard time justifying a continuation of concern after a single incident of SS. Anything else that happens, in my estimation, would be scattered and microscopic and probably reversible.
I experienced a moderate SS episode when I tried to add Effexor to Parnate. I was incoherent, talking jibberish, experienced dystonia and, and could not sit up. I had to lie flat and allow the episode to dissipate. I did have my parents take my temperature. It was only slightly elevated. For what it's worth, I haven't thought about this event for quite some time. With what I've learned about SS and neurotoxicity in the 8 years or so that have passed, I am totally unconcerned. I guess it's possible that the "concern center" of my brain was ablated by oxidative free radical damage, and no longer works properly.
:-)
- Scott
Posted by Squiggles on March 4, 2006, at 7:54:22
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 4, 2006, at 7:46:49
> Short of hyperpyrexia, seizure, and stroke, I would have a hard time justifying a continuation of concern after a single incident of SS. Anything else that happens, in my estimation, would be scattered and microscopic and probably reversible.
>
> I experienced a moderate SS episode when I tried to add Effexor to Parnate. I was incoherent, talking jibberish, experienced dystonia and, and could not sit up. I had to lie flat and allow the episode to dissipate. I did have my parents take my temperature. It was only slightly elevated. For what it's worth, I haven't thought about this event for quite some time. With what I've learned about SS and neurotoxicity in the 8 years or so that have passed, I am totally unconcerned. I guess it's possible that the "concern center" of my brain was ablated by oxidative free radical damage, and no longer works properly.
>
> :-)
>
>
> - ScottIt's good to hear an encouraging word. If that
is SS,then I didn't have it. I had withdrawal
induced seizure or maybe aneurysm or TIA or stroke
or something.It would be hard to explain how serotonin syndrome
could happen anyway, in the case of K w/d --
given the constancy of the other drugs.I think that SS is mentioned in combinations of
psychoactives, or overdose.Squiggles
Posted by linkadge on March 4, 2006, at 9:05:33
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by Phillipa on March 3, 2006, at 21:50:44
Hope you weren't reffering to me. The linkadge is a 23 yr old male :)
Linkadge
Posted by linkadge on March 4, 2006, at 9:09:38
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 4, 2006, at 7:46:49
In your case probably not, becuase the offending agent was added too acutely. But, in the case that an offending agent slowly produces serotonin syndrome over time, it is possable the subthreshold SS might be causeing neurotoxicity.
Linkadge
Posted by linkadge on March 4, 2006, at 9:11:49
In reply to Head injuries, posted by Squiggles on March 4, 2006, at 7:54:22
Yes it generally happens more with combinations of agents, but is not restricted to that.
I had SS on paxil, one of the most potent SSRI's
after a dose increase.Linkadge
Posted by Squiggles on March 4, 2006, at 10:00:25
In reply to Re: Head injuries » Squiggles, posted by linkadge on March 4, 2006, at 9:11:49
Funny, how i've always thought of the
SSRIs as the milder ADs; perhaps because
I have a friend who takes the archetypes
and the difference is immense - knock-out
drugs in comparison to SSRIs.As for management of SS here
are some ER guides:
http://www.emedicine.com/emerg/topic339.htmhttp://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2fa6.htm
http://www.biopsychiatry.com/sersynd.html
Particular drugs combinations, discontinuation,
abrupt restart, and overdose seem prominent risk factors.Squiggles
Posted by Larry Hoover on March 4, 2006, at 12:26:12
In reply to Re: Does Serotonin Syndrome Cause Brain Damage?, posted by SLS on March 4, 2006, at 7:46:49
> Short of hyperpyrexia, seizure, and stroke, I would have a hard time justifying a continuation of concern after a single incident of SS.
I have to agree with you, Scott. SS is a self-limiting condition, generally. Your body rejects your behaviour, you feel like sh*t, and you don't do it again. No damage, save incidental injury.
Lar
Posted by Phillipa on March 4, 2006, at 18:11:49
In reply to Re: Does Serotonin Syndrome Cause Brain Damage? » Phillipa, posted by linkadge on March 4, 2006, at 9:05:33
Link no I wasn't and I have a pic of you. Fondly, Phillipa
Posted by honeybee on March 6, 2006, at 9:28:15
In reply to Re: Does Serotonin Syndrome Cause Brain Damage? » linkadge, posted by Phillipa on March 4, 2006, at 18:11:49
Phillipa,
Back then, I sometimes wished that it was menopause (though I feel amply prepared for it now, considering the woozy night sweats and considerable overheating). Just so I could have some kind of explanation, but as it was, the docs just shrugged their shoulders and reassured me that it was a benign reaction and sent me on my "merry" way. For the record, this occured through my mid-twenties up until last year, when I went off Effexor and I turned 31. I haven't had a night sweat since.
There seem to be strong hormonal effects of ADs and I'll say that I'm not surprised (but scandalized) that there hasn't been more research. I've never been on birth control, but when I started Effexor suddenly my cycle was like clockwork (sorry everyone, with the TMI overload). I can say that I've already got the anecdotal evidence that there's some kind of hormonal effect of AD: in which the anecdote is me.
Thanks to everyone for entering the fray and offering their opinions on the SS potential of brain damage. My sense is that the depression packs more of a punch on my cognitive function than any potential serotonin syndrome did. But the jury's still out--as with so many other things...
Posted by Squiggles on March 6, 2006, at 9:41:58
In reply to Re: Does Serotonin Syndrome Cause BrainPhillipa, posted by honeybee on March 6, 2006, at 9:28:15
My doctor, a nurse, an elderly external doctor,
a neurologist, an ER doctor, and a gynecologist
all said, it was clonazepam withdrawal in my case.
In my case, i should stress; They knew my
medical history, age, and health status at the
time of examination.Squiggles
Posted by linkadge on March 6, 2006, at 11:22:44
In reply to Head injuries » linkadge, posted by Squiggles on March 4, 2006, at 10:00:25
By archetypes do you mean the TCA's ?
Yeah, I felt the TCA's were much stronger meds too. It seemed like they offered more support on different levels.
My mind could argue with the AD effect of SSRI's, wheras it was harder to argue with the TCA's, for a while at least.
Linkadge
Posted by Squiggles on March 6, 2006, at 11:46:23
In reply to Re: Head injuries » Squiggles, posted by linkadge on March 6, 2006, at 11:22:44
> By archetypes do you mean the TCA's ?
>
Yes, and the early antipsychotics such as
Haldol, and Carbamazepine, Thor***something;> Yeah, I felt the TCA's were much stronger meds too. It seemed like they offered more support on different levels.
They are good for psychotic depression, or
what is now called unipolar. I always thought
the SSRIs were for lighter depression, and
also, they are agitating, resulting in possible
suicidation in the interim of depression and
alleviation; whereas the old ones hit you like
a ton of bricks.
>
> My mind could argue with the AD effect of SSRI's, wheras it was harder to argue with the TCA's, for a while at least.
>I don't know what you mean;
Squiggles
>
> Linkadge
This is the end of the thread.
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