Anyone heard of serotonin syndrome? Anyone experienced it??

lsyorke, RN · Jun 22, 2005

Bupropion isn't an SSRI...is it? Gosh I hope it isn't 'cause I take it and Lexapro which IS an SSRI...going to have to do some reading I guess. I have felt those symptoms before though. Ewwww.

This is on Bupropion(Wellbutrin/Zyban)

" It works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine, an action which results in more dopamine, serotonin, and norepinephrine to transmit messages to other nerves. "

Yup, your on two drugs that increase serotonin. Bupropion claims to effect dopamine the most, but when you effect one neurotransmitter, you ultimately effect them all.

P_RN, ADN, RN · Jun 22, 2005

I don't take Zyprexa, but for several years I've been on one SSRI or another plus Bupropion. I found I function poorly when I attempt self withdrawal. The WB also causes serious hand tremors and dry MM.

For a very long, long time I haven't slept over 2h at a time. I used to take Melatonin years ago, so I tried it again about a month or so ago.

BAAAAD idea. Hallucinations, tachycardia, sleep paralysis, jerks etc. When I asked my head shrinker why he hadn't warned me, he said he's never seen that happen with "Melatonin". I wonder did I develop mild serotonin sx? Now he has me on ativan and ambien. More pills to rattle around....they LOVE to write Rxs.

passing thru · Jun 28, 2005

Dang, We All Might Just Accidentally Help One Of Our Co-allnurses Persons !! Be Sure And Get The Okay With Your Doc If You Are On Two And The Doc Hasn't Figured It Out Yet, So He Can Let You Down-- Off-- Easy................

MIA-RN1, RN · Jun 29, 2005

Well, it makes sense, then, to be careful with the over the counter herbal St. John's Wort, as well. It's often called "The Poor Man's Prozac" and I guess has similar effects on depression and mood swings--therefore on serotonin.

Yep, combining St John's Wort w/ an SSRI can increase risk of serotonin syndrome too.

hollyster · Jun 29, 2005

I'm not certain about what 5-HTP is... but the chemical name for serotonin is 5-hydroxytryptamine. The metabolic pre-cursor to 5-HT is 5-HydroxytyptoPHAN. Could this be what the "Health" food stores are selling???? If so, I think this is irresponsibly dangerous.
If the product was well absorbed and had good bioavailability, I would expect that it could really kill some people. Herbals and other "natural" products are "safer" than real drugs, because they are usually destroyed in the stomach or liver before they can reach their receptor targets... that is to say they are largely biologically inert. BUT taken in large enough doses, I would expect 5-HTP could push up the levels of active serotonin throughout the body.

5-HTP,valerian root,magnolia bark,SAM-E can cause adverse effects with SSRIs.

CHATSDALE · Jun 29, 2005

so interesting...

there are smart people behind my screen

PeachyOrthoRN, RN · Jun 29, 2005

You also have to be very careful taking migraine meds (speaking about the tryptans) with certain psychotropic meds can also induce serotonin syndrome. Heard that from a doc that I work with just recently.

nurse_suzan · Jun 29, 2005

I am on zoloft and my doc tried changing me to celexa for fibromyalgia. very bad side effects! i was on 100mg of zoloft, and she cut me back to 50 mg for a week then onto celexa, I COULD NOT function. it was horrible. i was exhausted, everything hurt, i couldn't concentrate, i thought i was going to end up in the hospital. she told me i was going through serritonin syndrome. put me back on zoloft and I felt better instantly. now she is trying to take me off the zoloft completely. I am taking 75mg this week, then 50 next week, then 25 the week after. I think I am ready to be taken off. She put me on it over a year ago due to my mom passing away, and I want to try to get off it now.

elizabells, BSN, RN · Jun 29, 2005

I've known kids who were going to take MDMA (ecstasy) to pre-load with an SSRI and 5HTP to supposedly heighten the effects and lessen the "comedown" - MDMA floods your system with serotonin.

carolinapooh, BSN, RN · Jun 29, 2005

5HTP, which you can get in the health food stores, is also a drug that can cause or contribute to serotonin syndrome.

I did not know that - that's good info. Thanks for passing that on.

carolinapooh, BSN, RN · Jun 29, 2005

Originally Posted by 1Tulip

I'm not certain about what 5-HTP is... but the chemical name for serotonin is 5-hydroxytryptamine. The metabolic pre-cursor to 5-HT is 5-HydroxytyptoPHAN. Could this be what the "Health" food stores are selling???? If so, I think this is irresponsibly dangerous.

If the product was well absorbed and had good bioavailability, I would expect that it could really kill some people. Herbals and other "natural" products are "safer" than real drugs, because they are usually destroyed in the stomach or liver before they can reach their receptor targets... that is to say they are largely biologically inert. BUT taken in large enough doses, I would expect 5-HTP could push up the levels of active serotonin throughout the body.

I don't know that I would say herbals are safer than drugs. I would be more inclined to say they're potentially MORE dangerous than drugs, OTC or script.

When you buy, say, 5-HTP at GNC or Whole Foods or wherever, there's no way to guarantee exactly what you're getting. One tablet could have X amount of the substance in it, and another tab could have Y amount. It's not regulated, controlled, or exact from pill to pill, brand to brand. (Edited to add: whereas, if you go into CVS and pick up generic Sudafed, while the fillers differ from the brand, it HAS to contain 30mg pseudoephedrine because the Feds say it has to - and it's checked to ensure that that's true, or CVS's generic supplier is in deep doodoo.)

It is, to say the least, scary as heck. The problem with herbals is most people THINK they're safer than drugs (not realizing that they ARE essentially drugs themselves), so they load up on them, go to the doctor and don't tell what herbs they're taking - and then they end up on some medication that screws everything up because it reacts negatively with the herbs they're on.

I don't necessarily agree with the FDA ban on ephedra (because at some point people have GOT to be responsible for their own stupidity), but that's probably why those people overdosed - they didn't think about the fact that certain herbs act on the body as drugs, with the same effects. They probably figured that since you could just walk in and buy it at the local Kroger or wherever, that it was perfectly safe to take. Not so. Overdose on it and it's dangerous.

Remember, salicylic acid, which is a component of aspirin (as acetylsalicylic acid) is from tree bark (white willow bark, I believe). And it's said that if the drug were discovered now, it would probably be a controlled substance due to its powerful effects on the body.

So I don't believe herbs are safer than drugs. And they're certainly not "biologically inert" - something that appears to be a common misconception.

CHATSDALE · Jun 29, 2005

people should inform themselves about what they put in their body but not everyone has the resources or the smarts to do that

it is sad when people make wrong decisions that negatively impact the rest of their lives