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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Zandy on July 17, 2010, at 18:33:15
Has anyone out there had serontonin syndrome? If so I was wondering how long does the nausea and muscle spasm/twitching last?
The meds that set it off were 20mg Prozac + Zofram (odansteron) + 30 mg Oxycodone.
I stopped the Prozac and Zofram 61 days ago. I am still on Oxycodone 30 mg. I am also on 3 mg of Ativan during the day for the muscle spasms/twitching, and Promethazine for the nausea.
I am starting to wonder if I am going to be permanently nauseas and have muscle pain.
Any info would be gratly appreciated!
Thanks!
Posted by Deneb on July 17, 2010, at 18:57:36
In reply to Serontonin Syndrome, posted by Zandy on July 17, 2010, at 18:33:15
Welcome to Psycho-Babble!
I'm surprised I don't have serotonin syndrome myself since I'm on a lot of SSRI. What was having serotonin syndrome like? Once I overdosed on Prozac and I think I got some symptoms of agitation. They went away in about a day. I don't think it was serotonin syndrome though.
I hope others answer your question! I'm interested in the answer too!
Deneb
Posted by Zandy on July 17, 2010, at 19:33:02
In reply to Re: Serontonin Syndrome » Zandy, posted by Deneb on July 17, 2010, at 18:57:36
> Welcome to Psycho-Babble!
>
> I'm surprised I don't have serotonin syndrome myself since I'm on a lot of SSRI. What was having serotonin syndrome like? Once I overdosed on Prozac and I think I got some symptoms of agitation. They went away in about a day. I don't think it was serotonin syndrome though.
>
> I hope others answer your question! I'm interested in the answer too!
>
> DenebMy symptoms came on rapidly when Zofram was added to the mix, they were:
Shivering, running fevers, sweating, drenching nightsweats, insomnia, muscle spasms/twitching head to toe (literally), metabolic acidosi (I had extremely high ketones in my urine), headache, confusion, severe diarrhea, and severe nausea (could not even sip water). I lost 10 lbs in a week and had to go to ER to get rehydrated.The only symptoms I have left are the nausea, not as severe, just feel sick to my stomach all day, and the muscle stuff.
I also had wierd stuff like rectal pain when I laid down at night and hiccups.
It was scary.
Posted by emmanuel98 on July 17, 2010, at 20:05:39
In reply to Re: Serontonin Syndrome, posted by Zandy on July 17, 2010, at 19:33:02
I doubt you still have serotonin syndrome, which is a time-limited phenomenon. But oxycodone routinely makes people nauseous. Addicts look forward to the nausea and even vomiting, since it means the drug is pure and working.
Posted by Zandy on July 17, 2010, at 20:23:42
In reply to Re: Serontonin Syndrome, posted by emmanuel98 on July 17, 2010, at 20:05:39
> I doubt you still have serotonin syndrome, which is a time-limited phenomenon. But oxycodone routinely makes people nauseous. Addicts look forward to the nausea and even vomiting, since it means the drug is pure and working.
Wow, Ididn't know that. I will have to talk to my pain management doctor about this. Is there any pain killer that you know of that I could switch to? I have already tried Opana, but it gave me ileus.
I have just had a series of MRIs done and go back to see the back surgeon Wednesday. I am praying he will be able to do surgery to stop the pain and I can get off these pain medications once and for all.
Please let me know if there is anything else I can take in the mean time.
I can't get corticosteroid pain injections. I was getting them for 2 1/2 years. I began to become very weak and sick...turns out they were shutting down my HPA axis the whole time. I finally went into adrenal crisis befor anyone figured it out. I am not sure if the muscle stuff is from that as it takes a long time to recover...some have told me up to a year.
So maybe the nausea IS from the oxycodone because he had just increased my dosage in the same time frame that I was given Prozac and Zofram.
If I am able to have a surgical correction to my back I will have to wait until Feb 2011 because of the adrenal crisis. Can't have surgery until one year after that cause my body needs to recover to handle the stress of the surgey.
Thanks for the info, please let me know if there is anything else I can take.
Thanks!
Posted by Phillipa on July 17, 2010, at 23:41:11
In reply to Re: Serontonin Syndrome, posted by Zandy on July 17, 2010, at 20:23:42
I understand the adrenal crisis as my Mother ended up with Addison's disease from too much cortisone but this was when cortisone first came out and they knew no better. Boy you sure are having a rough time. It's good that you have a pain management doc. Good idea to find out an alternative maybe a pain patch for now? Phillipa
Posted by ed_uk2010 on July 18, 2010, at 12:21:30
In reply to Serontonin Syndrome, posted by Zandy on July 17, 2010, at 18:33:15
Oxycodone frequently causes nausea. Occasionally, it can also cause muscle twitching (myoclonus), especially when very high doses are being used.
If promethazine is not controlling the nausea, there are other anti-nausea meds that you could try eg. metoclopramide (Reglan) or prochlorperazine (Compazine). Alternatively, switching from oxycodone to a different analgesic could help. Transdermal fentanyl (Duragesic) is one choice for severe chronic pain. Also, non-opioid pain meds can often allow a reduction in opioid doses, and this may reduce side effects such as nausea.
Posted by ed_uk2010 on July 18, 2010, at 12:24:14
In reply to Re: Serontonin Syndrome, posted by Zandy on July 17, 2010, at 20:23:42
>Can't have surgery until one year after that cause my body needs to recover to handle the stress of the surgery.
Couldn't you have surgery earlier with hydrocortisone treatment prior to and during surgery...and then tapered after?
Posted by Zandy on July 18, 2010, at 19:47:04
In reply to Re: Serontonin Syndrome, posted by ed_uk2010 on July 18, 2010, at 12:24:14
> >Can't have surgery until one year after that cause my body needs to recover to handle the stress of the surgery.
>
> Couldn't you have surgery earlier with hydrocortisone treatment prior to and during surgery...and then tapered after?
>
>I am scared to death to ever have any type of cortocosteroid put in my body again. When I had the adrenal crisis the attending physician put me on 30 mg of Hydrocortisone (20 mg in the morning and 10 mg in the evening) and referred me to a Endocrinologist after I was discharged. I saw the Endocrinologist a month later and he weaned me off the Hydrocortisone over 7 weeks. The pain I felt body wide day in and day out was so intense I didn't want to go on living.
I still experience the body wide pain to a lesser extent, I sometimes wonder if my HPA axis will ever get back to normal.
After this experience I am literally scared to death to have any type of corticosteroid put in my body again. I was also told that it could shut down the whole thing again if I do.
All my levels, the things your adrenals make; Cortisol, DHEAS, Estrogen, Testosterone are low. At first we tried to replace the estrogen but that made me more nauseated. Then we tried DHEA which made the body wide pain better, but gave me severe insomnia and heart palpitations. It seems like anything they try to do to fix the situation makes it worse. It is very frustrating.
So I am toughing it out, hoping my adrenals will start up, and my pituitary gland also had stopped making vassopressin (aka the ant-diuretic hormone) and I can't hold any water, I pee constantly, even after one sip of water.
I am scared if I go for the surgery now and take Hydrocortosone my HPA axis might never come back.
It has been a total nightmare. Thank you so much for your advice and concern. This has been hard on my whole family and everyone, including the doctors, are at a loss as of what to do for me.
Posted by Zandy on July 18, 2010, at 19:51:43
In reply to Re: Serontonin Syndrome » Zandy, posted by Phillipa on July 17, 2010, at 23:41:11
> I understand the adrenal crisis as my Mother ended up with Addison's disease from too much cortisone but this was when cortisone first came out and they knew no better. Boy you sure are having a rough time. It's good that you have a pain management doc. Good idea to find out an alternative maybe a pain patch for now? Phillipa
Wow, that is my worst fear, that my adrenals won't start back up again. I really feel for your Mother, poor thing. How is she doing?
I tried the Fentynal Patch about a year ago, but I didn't get any good relief from it and eventually had to take it off because the rash became so severe, even if I moved it around. But thanks soooooo very much for the input. I am in a desperate state and appreciate any and all input!!!
Posted by Zandy on July 18, 2010, at 19:58:05
In reply to Re: Serontonin Syndrome, posted by ed_uk2010 on July 18, 2010, at 12:21:30
> Oxycodone frequently causes nausea. Occasionally, it can also cause muscle twitching (myoclonus), especially when very high doses are being used.
>
> If promethazine is not controlling the nausea, there are other anti-nausea meds that you could try eg. metoclopramide (Reglan) or prochlorperazine (Compazine). Alternatively, switching from oxycodone to a different analgesic could help. Transdermal fentanyl (Duragesic) is one choice for severe chronic pain. Also, non-opioid pain meds can often allow a reduction in opioid doses, and this may reduce side effects such as nausea.
>
>
> They are running law suit commercials out here on Reglan, so I think I would pass on that one...but what is Compazine? I am going to Google that one and look at the side effects, as I am now extremely weary of medication.Tried the patch about a year ago, but didn't have good pain relief and got a severe rash.
I am verrrrrry greatful for your suggestions. Thank you so much!
>
> I am also greatful you alerted me to the side effects of the oxycodone. Today I reduced my dose to see if anything improves. Thanks again!
Posted by Zandy on July 18, 2010, at 20:01:03
In reply to Re: Serontonin Syndrome, posted by emmanuel98 on July 17, 2010, at 20:05:39
Thank you for letting me know Oxycodone can cause nausea. I reduced my dosage today to see if I can get some improvement. Thanks so much!
Posted by Phillipa on July 18, 2010, at 20:15:21
In reply to Re: Serontonin Syndrome » Phillipa, posted by Zandy on July 18, 2010, at 19:51:43
Zandy this was back in the 50's and 60's. She'd enter the hospital be given ACTH and that would work. The last time it didn't due to unforseen extenuating circumstances broken bake which kept her bedbound in hospital she passed a pulmonary emobolish and is deceased at age of 48. If happened today so much would be different. So hang in there the endo knows what he's doing. Phillipa
Posted by emmanuel98 on July 18, 2010, at 20:36:08
In reply to Re: Serontonin Syndrome » emmanuel98, posted by Zandy on July 18, 2010, at 20:01:03
I think all opiods cause nausea, though my experience with morphine is that it caused the least. There's also demerol, dilaudid (sp?) which work differently from traditional opiates. Worth a try.
Posted by Zandy on July 19, 2010, at 8:50:39
In reply to Re: Serontonin Syndrome, posted by emmanuel98 on July 18, 2010, at 20:36:08
Thanks for the list of pain meds. I called my doctor this morning to and I am going to bring in this list to discuss them with him. You guys in this community are the best! I can't thank you enough!
Posted by ed_uk2010 on July 19, 2010, at 15:25:58
In reply to Re: Serontonin Syndrome » ed_uk2010, posted by Zandy on July 18, 2010, at 19:58:05
>They are running law suit commercials out here on Reglan..........
How errrr American ;-) Nothing like that here. Metoclopramide (Reglan) is often a useful drug to use on a short term basis. Long term use is not advisable.
>but what is Compazine?
Prochlorperazine is another anti-nausea medication. It is often used for nausea caused by opioids. It is suitable for short term use.
Posted by Zandy on July 19, 2010, at 19:39:49
In reply to Re: Serontonin Syndrome, posted by ed_uk2010 on July 19, 2010, at 15:25:58
Today my Pain Doctor workrd me in and switched me to 50 mg of Demerol twice a day. I have trouble with reactions to generics so the pharmacy had to order it. I will up date you if it works or not. I just pray I do not have an adverse reaction to this one. Thanks to everyone who responded.
Posted by ed_uk2010 on July 20, 2010, at 17:35:41
In reply to Re: Serontonin Syndrome, posted by Zandy on July 19, 2010, at 19:39:49
> Today my Pain Doctor workrd me in and switched me to 50 mg of Demerol twice a day. I have trouble with reactions to generics so the pharmacy had to order it. I will up date you if it works or not. I just pray I do not have an adverse reaction to this one. Thanks to everyone who responded.
Hi there,
Demerol is a short-acting opioid which is used almost exclusively for acute pain eg. post-op. Demerol has a toxic metabolite and is not appropriate for chronic pain. After a single dose of Demerol, pain relief can be expected to last about 3 hours.
Posted by jerrypharmstudent on July 21, 2010, at 16:19:09
In reply to Serontonin Syndrome, posted by Zandy on July 17, 2010, at 18:33:15
> Has anyone out there had serontonin syndrome? If so I was wondering how long does the nausea and muscle spasm/twitching last?
>
> The meds that set it off were 20mg Prozac + Zofram (odansteron) + 30 mg Oxycodone.
>
> I stopped the Prozac and Zofram 61 days ago. I am still on Oxycodone 30 mg. I am also on 3 mg of Ativan during the day for the muscle spasms/twitching, and Promethazine for the nausea.
>
> I am starting to wonder if I am going to be permanently nauseas and have muscle pain.
>
> Any info would be gratly appreciated!
>
> Thanks!
>
>Sounds like you have a mild case. I had a case of SS on Nardil and cough medicine (dextromethorphan) - -VIOLENT shaking, sweating and very close to kidney failure. Was in the ICU for a couple days. They gave me Ativan and that antihistamine with anti-serotonin properties. Be careful.
Posted by MaybeSo on July 28, 2010, at 9:00:34
In reply to Re: Serontonin Syndrome » Zandy, posted by jerrypharmstudent on July 21, 2010, at 16:19:09
Over the years I have had certain reactions to stopping/starting meds, but SS was totally different.
For the first day I thought I had the worst flu ever. Fever, horrible nausea and diarrhea but never vomited. The shaking/shivering was so bad and so constant that I broke two caps (second molars back).
I think switching from generic to another generic and back to name brand within 6 weeks is what sent me into SS.
Posted by Jeroen on July 29, 2010, at 10:42:33
In reply to Serontonin Syndrome, posted by Zandy on July 17, 2010, at 18:33:15
ANOTHER VICTIM OF PSYCHIATRY --> Zandy
propably an incompetent doctor prescribed all those seratonin medicine together and boom
toxic seratonin psychosis
psychiatry are fachists!!! please be carefull with what these apes prescribe to you!!!
Posted by Dr. Bob on July 31, 2010, at 22:55:20
In reply to ANOTHER VICTIM OF PSYCHIATRY --) Zandy, posted by Jeroen on July 29, 2010, at 10:42:33
> psychiatry are fachists!!!
Please don't exaggerate.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person, and I'm sorry if this hurts you.
More information about posting policies and tips on alternative ways to express yourself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by MaybeSo on August 1, 2010, at 9:39:01
In reply to Re: please be civil » Jeroen, posted by Dr. Bob on July 31, 2010, at 22:55:20
Zandy, I hope you are feeling better and your symptoms have stopped. I realized I didn't answer the actual question.
For those who later come to this conversation for reference, my worst symptoms were over in about 4 days. I felt a little shaky for about 3 more days.
This is the end of the thread.
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