serotonin syndrome

[Egg_Head]

Hi all, I have been having problems sleeping for many years
and I have blamed it on the anti depressants I was prescribed. My new doctor
agrees they may be the cause and has given me a new anti depressant medication with
sedative properties to take at night to help with sleep. They work well but I
feel angry all the time; like I want to tell everybody to ...., well you can
guess. I wonder if I am taking too much of the same type of medication as both
have a similar effect on serotonin levels. I’m wondering if I may have a mild serotonin
syndrome. It feels to me as I’m swapping one set of symptoms for another. The Pharmacist
agrees with me it takes very little medication to have a big effect on me as I’m
taking a very low dose of both medications. When I spoke to the Pharmacist he
suggested I wean myself off the first anti-depressant and eventually take only
the new one; all under my doctors guidance of cause. Have any of you had similar
experiences?

[blondguy]

Hello EH

Thanks for reaching out and a good topic too!

I have had depression/anxiety for many years and understand what you are going through. It can be a pain with adjustment to meds. How long were you on the the first anti-depressants, and were you angry on those too? Or just the newer ones? How long have you been on the new AD's?

I have been on the same SSRI since 1997 for acute anxiety and depression. I did have some difficulty sleeping so I stayed on the first AD that was working and my GP put me on a low dose benzo before bed and now sleep well but wake up really well rested, not spaced out.

The anger is usually a symptom of untreated or early days of taking AD's. Its good that you have a great doc.

Excuse the questions, just trying to get a better idea of whats happening. Sometimes we have to feel worse before we get better where AD's are concerned.

You are definitely not alone EH

Kind Thoughts

Paul

[Egg_Head]

Hi Paul and thanks for responding. I have been on the old
A.D’s for about 10 years; recently due to a bout of severe depresion I was advised to double the dose from a very
low 10 Mg one to what many doctors considered the minimum dose of 20 Mg. I was also
prescribed a new one to take (12Mg) at night to help with sleep (still taking
the old one in the morning) but found I was too lethargic the next day. Now I
take half of that dose at night. I still feel a little hung over but not too
bad and was wondering if that will settle as my body adjusts. I still seem to
get angry at the drop of a hat. A few days ago I decided to cut down from 20Mg
of my old to 10Mg as I have been on for 10 years, plus 6Mg of the new one at night.
I understand we can’t mention medication names on this forum so I hope what I
have written make sense.

[White_Rose]

Hello EH

I understand what you are saying about you medication and the frustrations you are experiencing. I have also been in that situation. By the way you can mention the type of medication such as SSRI, SNRI, Tricyclic etc. It is the exact name that is not allowed as others may feel they shouldn't take it if you had a bad reaction etc.

People do adjust to different meds over time. I took SSRIs for a long time. They were never really effective and had different effects on my sleep. I now take a Tricyclic AD which has been amazing. They put me to sleep so fast I only took them as I was getting into bed. Now I take them with my evening meds and I get to sleep easily. And usually stay asleep all night.

Have you discussed this with your prescribing doctor? It's not usually a good idea to change the amount of a medication you take or stop taking it suddenly. I was taking a SSRI and started at 10 mg. This was upped to 20mg then 30mg. A psychiatrist thought I may have serotonin syndrome but my GP disagreed. In the end it was discovered my AD was interacting with a newly prescribed drug prescribed by the oncologist after cancer treatment. This combination was producing a serotonin syndrome-like effect and was truly the pits. I was extremely unwell.

Ask your doctor to review all meds you are taking in case there is some interaction. I had a similar experience with the same AD about five years previously. This time it was in combination with a strong pain

killer. So no surprises that I don't take that AD anymore.

By the way the amount of a drug you are prescribed does not necessarily mean you are taking a large amount or a small amount. I take 75mg of my current AD. The more usual amount is 100-150mg. Whereas I took 10-20 mg of the previous AD. You cannot make a comparison of the amount of AD prescribed.

I hope this has helped.

Mary

[blondguy]

Hi EH

I hope you are still checking you mail and thankyou for posting back too

Mary has made a good point regarding the dosages. I was just popping in to see how you are going..

I take SSRI's and have been doing so for 20 years.

You are not alone here

Kind Thoughts

Paul

[geoff]

hi EH, changing medication is such a pain because of the possible interaction that could happen but you won't know until you start taking a new one.
For me I was never given any time to dry out and this was with half a dozen different AD I tried, so was told to stop taking the one I was taking and start on the new one at a low dose straight away, but from memory they were different types, 1 being a SSRI and the other SNRI. Geoff.

[Ben1]

Hey guys!

Serotonin syndrome is a really interesting thing to bring up on a forum like this as it is a potential danger for people taking any type of AD medications. In particular, there are some specific dangers that put patients at increased risk.

If you are double dosing or ODing on antidepressants, like taking MDMA or LSD or take some specific supplements, serotonin syndrome is much more likely. Mild serotonin syndrome is possible and it's probably best to let your doctor know if you experience any symptoms of serotonin syndrome. This is because in rare circumstances, severe serotonin syndrome can be fatal.

Take care of yourselves guys!
-Ben 🙂

[Egg_Head]

Hi all, and thanks to all who replied to my post,

I guess I’ve been a slow in getting back to you all I’ve just not felt like writing.

White Rose, My starting dose of SSRI was 20Mg but my
prescribing doctor told me to cut that dose in half when I told him I was having a lot of trouble with sleep. I was on that dose for about 9 years I guess. While attending a new doctor for the first time he asked what medications I was on and when I said 10Mg of SSRI he said “that dose wouldn’t be doing a thing as it was too low.” My first thought was, good, I’ll stop taking altogether. But then I thought we are all different and I had felt better when I was on that dose. When I was referred to a specialist for help during a period of feeling low he recommended that I up the SSRI to 30Mg and take 20MG of a tricyclic AD also.

That advice scared the living daylights out of me as I hate the idea of taking any medication let alone that much. I did up the dose of SSRI but only half of the tricyclic AD. Right now I’m on just 5Mg of the tricyclic and back to 10Mg of SSRI. Yes, I’m doing all this under my GP’s knowledge and advice. I recently sat down with my Chemist and had a medication review so we could discuss all my medications and any reaction between them.

Hi Paul, Yes I’m still checking in, just not replying as much as I might. I find all the advice or sharing of experiences on this forum useful. There is no obligation to follow that advice, or any advice we receive in life. However, what must be remembered is that we are sharing our experiences with each other and it helps to know that we are not alone in what we are experiencing. As for the doses of any medication I understand we all react differently to meds for a whole lot of reasons. I find just a little seems to do a lot; even my Chemist thinks that in my case I react to small doses of everything.

Perseverance and maintain a sense of hope is all we can do, that and support the person next to you.

[White_Rose]

Hello EH

What a great reply. I hope your current medication regime is working for you. I think that sometimes doctors lose track of us being individuals and assume we will all react to meds in the same. Occasionally doctors are not aware of some side effects so tell us these things are not related to the meds. And in instances such as yours, standard doses do not apply. Some of those medication reviews with the pharmacist are very beneficial. It certainly helps where there are known interactions between drugs. The real problem of is when you have a reaction to, or interaction between two drugs. This is unknown territory and this where doctors need to be alert to reactions other than those in their textbooks.

I had a bad reaction to a pain killer and the doctor told me this did not happen and I was just having a bad day. I became very unwell. Continue to take care of yourself.

Mary

[A2D2]

Jumping in late here but just to further muddy the waters, I notice a difference between one generic and another at the same dose. Of course, the pharmacist told me I was imagining it but I have tested it several times and yep, I get anxiety and shaking from one brand, but not from the other (even at a higher dose). I have put it down to absorption rates varying depending upon the carrier.

I never had a name to put to it until now. So with my great news about there being yet another variable to consider comes some thanks as well.