Just a different perspective here. I took 40 mgs. Paxil daily for over 25 years. I took many OTC cough syrups, etc. over the years and never experienced serotonin syndrome. No one ever warned me of this, I just recently became aware that this could even happen.

I am 70 and have been taking Celexa 40mg and Klonopin 3mg for 12 years. About 6 months ago I started getting headaches. They continued to spread and now whenever I fall asleep my feet/ankles, abdomen, and sinuses are burning at pain level of 9. I might not be metabolizing the drugs as well as I have aged.? I was so desperate that I checked into nearby hospital. They prescribed Gabapentin 900 mg daily. That was about 1 week ago. I have very little relief yet, does this take longer to work? Is it possible that I have mild serotonin syndrome that is causing this neuropathy?

A few weeks ago I began feeling weird. It didn’t go away, it got worse. Dizziness, nausea, vomiting, diarrhea, sharp stomach pain, restlessness, clumsiness, confusion, this weird feeling of being cold but having flashes of full body sweats & no fever & extreme fatigue but struggling to sleep were my primary symptoms. It started gradually but increased rapidly and I did a deep dive into my symptoms and my meds. I SHOULD HAVE CALLED A DOCTOR OR GONE TO THE ER/URGENT CARE RIGHT AWAY. It was the weekend, I didn’t want to be a burden, couldn’t drive & definitely didn’t want an ambulance. I tried one of those online doctor visits but it was a scam. THIS WAS INCREDIBLY STUPID ON MY PART.
My psychiatrist had weaned me off Pristiq and onto Trintellix in November (after a round of ECT) and I felt great! In January my insurance stopped covering Trintellix (which is exorbitantly expensive) and while I worked on acquiring coverage, I went back on Pristiq and decided to up my dosage (w/o telling doctor) because I thought that would help mimic Trintellix (dumbass). In March, I went back on Trintellix and started weaning off Pristiq. This is when everything went wrong. I was taking 20mg Trintellix + 100mg Pristiq + 450mg Wellbutrin + 300mg Trazodone + my other common meds. Sounds a little toxic, don’t ya think? I gave myself Serotonin Syndrome.
I immediately stopped all anti-depressants and upped my water intake. On the 2nd day I felt better, 4th day much better & even though I started having withdrawals I waited until the 7th day to take Trintellix, then slowly added Wellbutrin & Trazodone. I feel so much better. My doctor’s more than a bit cranky with me.
Moral of the story? YOU ARE NOT A PHARMACIST OR DOCTOR OR SMART ENOUGH TO CHANGE YOUR MEDS because Serotonin Syndrome is deadly. Please be smarter me.

My problem now is that I have a weird feeling in my tongue that makes me talk for 8-10 hours a day, sometimes more and sometimes less.... I mean, I like to watch tennis and play games on my laptop, but when I get this feeling in my tongue, and the tennis match starts, I miss the match and go to talk for 7- 8 hours and the match is over and I don't see it....and i like to play video games on a laptop and this feeling comes to me, I turn off the game and turn off the laptop and go to talk for 7-8 hours, then play....I think maybe I have serotonin syndrome maybe not....i am not soo sure, because this is the only reasonable diagnosis to this condition i have but maybe it's very mild Maybe it's not severe, maybe it happened to me because of the pills for depression that I took for 12 years that prevent the re-absorption of serotonin, such as Zoloft, Effexor, Seroxat, Faverin, Cibralex, and Abilify. I mean, all kinds of pills I took.... So I read on the Internet that there are medications that treat serotonin syndrome. Or prevents the secretion of serotonin, so it decreases in the body.... And these pills are 4 types
- Methysergide (Deseril) (Sansert)
- Methylergometrine or Methylergonovine (Methergine)
- Cyproheptadine (Periactin)
- Pizotifen or Pizotyline (Sandomigran)
The first name is the scientific name and in brackets the trade name
These pills and their function inhibit the secretion of serotonin, so it decreases in the body, and for those who reduce it, I think the feeling of the tongue will decrease, which makes me talk 10-12 hours a day....but I wanted to know which is the best kind of these 4 pills that prevent the secretion of serotonin, the best efficacy and the least side effects I can take..... I am currently taking Seroquel XR, which one of these 4 conflicts with Seroquel XR or not?
Sorry for taking so long, but I wanted to explain my case in detail so that anyone can help me....I am waiting for a response from you....Thank you in advance and sorry for the inconvenience

My psychiatrist always warns me about this anytime I start a new psych medication. I was sick from a reaction from Zofran last week - I asked the doctor if it might be serotonin sydrome. She said if it was serotonin syndrome, we would not be sitting there having a calm conversation.

Ultimately it is your body.
The pharmacist will usually catch the prescriptions , and if asked they will check the over the counter drugs for interactions.

Looking at my meds @drug.com, I see the serotonin syndrome warning on several medication interactions, but I've never experienced it. It's confusing when so many list it as a possible interaction. My PCP and psychiatrist both know my medication list well, and have never expressed a concern. I think it's a good idea to have a medication review from time to time with a PCP and if appropriate, a psychiatrist. Pharmacists, as others have mentioned, are a good resource, as they tend to keep up on medications better than most doctors.

Jim

So good to find this website! Just want to pass along my recent experience with SSRI side effects. Five months ago I experienced high level anxiety even though I’ve been on Fluoxetine for 6-8 years. Approximately two weeks later my hands started trembling and I became weak, fatigued and lightheaded. My primary doctor ordered lab tests, which came back normal. Six weeks later I was able to get an appointment with a neurologist and my labs and visit were also ‘normal’. Shortly after my visits to the two physicians I was feeling worse and was becoming confused. I forgot to take my Fluoxetine meds for two days. On the third day, my symptoms seem to lessen a bit. I then researched Fluoxetine side effects and came across information regarding SSRI toxicity. Knowing that I should never immediately stop taking an SSRI, I talked to a psychiatrist about my symptoms and my theory regarding SSRI toxicity. She had never heard about this but checked while we were talking, and agreed with me. She said that I could quit Fluoxetine and should not have a problem, but I was to check back with her regarding depression blowback. Two health care professionals did not diagnose my symptoms as SSRI toxicity and it was news to the psychiatrist. I am feeling almost normal now and I am trying to get the word out about SSRI toxicity, specifically with seniors like me who are not metabolizing drugs as they had in the past. Any advice or kind comments would be appreciated!

SSRI toxicity is the same thing as serotonin syndrome which is the body’s reaction to having too much serotonin in the neural synapses of your brain. Serotonin is one of the many neurotransmitters in the brain. Neurotransmitters are how neurons “talk” to each other.
You get serotonin syndrome usually when you take too many drugs that affect serotonin levels.

I do wonder why you experienced this if you were taking your usual dose, unless you were taking other drugs that influence serotonin. These could be other antidepressants, tramadol, codeine, cocaine etc.
Above, Cathy said she experienced it after taking Mucinex DM. “DM” stands for “dextromethorpan” which is a chemical alternative or isomer of codeine. Unlike codeine, it can’t be used for pain, but it will, like codeine, suppress coughs. It isn’t addictive nor does it cause “tolerance” which is where you have to increase the dose of a drug to get the same effect. So if Cathy took the Mucinex DM with other serotonin influencing drugs, that might have caused it. Sensitivities to serotonin probably vary, so a dose that causes symptoms in one person may not affect another person.
The treatment is “supportive”—IV fluids and benzodiazepines for the agitation and tremors. Benzos include drugs like Valium, Xanax, Ativan etc.

I've been an RN for over 30 years and this has always been a problem, and it's no better since the initiation of electronic health records! I worked in home health and the visit summary that patients get from our local providers are useless - they have the same med list on there at the end of the visit, even if I've told them I'm not taking certain meds anymore! HOW can a home health RN or family member that wasn't at the appointment know what meds someone is actually taking? It's a huge problem, especially with older folks who may not remember everything their provider told them. You think there would be some way to alert a provider (like a pop-up that says "warning! potential for adverse reaction with current medications" or something along those lines) whenever a provider enters a new med order.

Anytime you go in for an appointment or procedure you generally get asked about meds MULTIPLE times but that does not address the problem, because I was prescribed a couple of meds after orthopedic surgery that caused my resting heart rate to be in the 90s (it's usually in the 60s) so I knew something was up. I looked online for drug interactions and stopped those meds immediately and the issue resolved. WebMD is a reputable source for health info, and it has a drug interaction check - you can do a quick search. But I'd recommend confirming what you find with a pharmacist and the provider that prescribed the medication, especially if you're not a medical professional. Bottom line: at a minimum, you should ALWAYS check any new medication with a pharmacist before you add ANY new drug or supplement, prescribed or not. You HAVE to be an advocate for yourself these days and don't let ANYONE dismiss your concerns. If they do, find a different provider.