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Accidental Serotonin Syndrome AKA You Aren’t A Pharmacist
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.
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I too have had serotonin syndrome and it is scary. Mine is a similar story but different details from "brewnews" above. My seratonin overdose was caused by a supplement called SAMe.
Folks, be careful. I suggest making changes to your meds gradually, and with a doctor's approval. Journal the changes, and watch for signs of improvement or symptoms of problems.
Also, make one med change at a time if possible. In other words, don't try three new things all at once - then you won't be sure what's working or what's causing problems. Be aware that serotonin syndrome and other problems can take weeks to present as the buildup on your system becomes toxic. That's where the journal comes in - so you can see "what's changed" on a timeline.
Remember that vitamins, herbals and supplements are meds too, so include them in your journal along with prescription meds.
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10 ReactionsI could not have said this any better. I learned long ago that I had no idea if a prescribed med was helping or not. The journal is an excellent idea. It does have to be a formal journal. Just a spiral notebook will work fine. The entries can be one sentence or many. Take that to the doctor visit so you can describe in your words , how a med made you feel. I sometimes forgot what I wanted to tell a doctor, so I kept notes before the visit. Then I wrote what the doctor said after i talked with him. This helped me greatly.
Only one medicine change, or supplement added, for one month's time works for me.
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7 ReactionsI am correcting myself! I meant it does NOT have to be a formal journal. Writing a daily line or two in a spiral notebook, helped me realize if a new medicine or vitamin/ supplement, helped me or not. And I change only one thing at a time, giving it at least 4 weeks to see if it is helping me or not. In other support groups, like on Facebook, I read people saying " I started an antidepressant and it didn't help me at all". They had only taken it two days!
Or they wrote "I took so and so yesterday and today I am flipping out and having terrible symptoms". Unless we are truly allergic to a medicine, I do not believe it happens that fast. I have spent two decades reading and trying to understand my diseases. it helps me to learn all I can.
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2 ReactionsHello. Did you develop a rash with serotonin syndrome?
No, no rash in my case - but extreme shivering, confusion, excessive sweating, as well as low levels of other symptoms. Please search "serotonin syndrome symptoms" and you'll see skin rash is not on the list. Hope this helps!
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Thanks. Here is something I found:
Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects, including macular rash. So, the rash you describe may represent a side effect as opposed to an allergic reaction.