Understanding Serotonin Syndrome

Dani Henson, a mod on the chronic pain forum, posted this and I think this is very good.  I don't take medications like this but many of you do so I feel you need to be educated about this.  We all should know what we are taking!

 

I also found this great link by the National Institute of Health that explains this, too, and list more of the medications that could possibly cause this syndrome.  Always speak with your doctor before going on or off any medication or supplement.  It's just excellent to be an informed patient.  It keeps doctors on their toes.

 

http://www.nlm.nih.gov/medlineplus/ency/article/007272.htm

 

Sherrine

 

1. What is Serotonin Syndrome?

Serotonin syndrome occurs when you take medications that cause high levels of the chemical serotonin to accumulate in your body. It can occur when you increase the dose of such a drug or add a new drug to the ones you take already. Certain illicit drugs and dietary supplements also can cause serotonin syndrome.

  2. What medicines / supplements can cause Serotonin Syndrome?

A number of over-the-counter and prescription drugs can lead to serotonin syndrome, especially antidepressants. Illicit drugs and dietary supplements also can cause the condition. These drugs and supplements include but aren't limited to:

• Serotonin reuptake inhibitors (SSRIs), antidepressants such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine, paroxetine (Paxil) and sertraline (Zoloft)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants such as trazodone and venlafaxine (Effexor)
• Bupropion, an antidepressant and tobacco-addiction medication (Wellbutrin, Zyban)
• Monoamine oxidase inhibitors (MAOIs), antidepressants such as isocarboxazid (Marplan) and phenelzine (Nardil)
• Anti-migraine medications such as almotriptan (Axert), naratriptan (Amerge), sumatriptan (Imitrex) and zolmitriptan (Zomig)
• Pain medications such as fentanyl (Sublimaze), meperidine (Demerol), pentazocine, (Talwin) and tramadol (Ultram)
• Lithium (Eskalith, Lithobid), a mood stabilizer
• Illicit drugs, including LSD, Ecstasy, cocaine and amphetamines
• Herbal supplements, including St. John's wort and ginseng
• Over-the-counter cough and cold medications containing dextromethorphan (Robitussin DM, Sudal DM)
• Anti-nausea medications such as granisetron (Kytril), metoclopramide (Reglan) and ondansetron (Zofran)
• Linezolid (Zyvox), an antibiotic
• Ritonavir (Norvir), an anti-retroviral medication used to treat HIV/AIDS

  3. What are the symptoms of Serotonin Syndrome?

Serotonin syndrome symptoms typically occur within several hours of taking a new drug or increasing the dose of a drug you're already taking. Signs and symptoms include:

• Agitation or restlessness
• Confusion
• Rapid heart rate
• Dilated pupils
• Loss of muscle coordination or twitching muscles
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goose bumps

Severe serotonin syndrome can be life-threatening. Signs and symptoms include:

• High fever
• Seizures
• Irregular heartbeat
• Unconsciousness

Refrences and informative links

~~> http://www.mayoclinic.com/health/serotonin-syndrome/DS00860

~~> http://en.wikipedia.org/wiki/Serotonin_syndrome

~~> https://health.google.com/health/ref/Serotonin+syndrome

I know that the combination of drugs I'm on can cause Serotonin Syndrome, and it's likely I'm experiencing some of those symptoms - the agitation, the twitching muscles, the restlessness, the heavy sweating, the dizziness....all quite likely indicative of problems. Up until about a week ago, my meds were working quite well. Then we increased the Cesamet, and I've suddenly developed pain in the small joints of my fingers and hands. I can barely bend the fingers closed - they feel swollen and I don't have the full capacity to grab things.

I'm sure that this is my Carpal Tunnel flaring, but the timing is weird...why did this start right after increasing the Cesamet? I will have to make an appointment with my doctor to discuss my various meds. I can tolerate some of the Serotonin Syndrome symptoms if it means feeling better overall, but I feel like I'm starting to slip backwards again.

Pam

Great information! Being on Savella and sometimes using Flexeril is worrisome
to me. I'm aware of all the side effects and should any symptoms show up, I'd
contact my rheumy in a heartbeat. Over the years, I feel like a guinea pig being
subjected to one med or another...always choices to make :)

Hugs, Robin