Has anyone had serotonin syndrome? Treatment and outcome?

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.

@5148branelly
Yes, my dosage was increased from 20 mg to 40 but, in the past, I have occasionally increased dosage or decreased it according to how I felt. I had not taken any other drugs, just my usual vitamins. I think it may be due to my aging that may have caused a metabolism problem with Fluoxetine. I was prescribed Prozac shortly after it arrived on the market, I think it was late 1980’s. That drug probably saved my life and I was able to quit Prozac after time went by. When life’s stresses became difficult I would, upon occasion, return to Prozac. After the death of my husband, I was on Medicare and was prescribed Fluoxetine and have been on it for several years. I am grateful that wonderful antidepressants are on the market, but on occasion things do go awry.

In the late 1980's after being prescribed Prozac for menopausal symptoms was exactly when I had a serotonin storm. Awake for about 4 days, muscle clonic/tonic movement, extremely restlessness....it was awful and thought surely I would die. I react exactly the same way to SNRI's so that's no help. Physicians have been frustrated with my refusal to take any medication that effects serotonin but they haven't experienced what I did! There are so many medications, vitamins and herbs that will effect serotonin levels so be very prudent in looking them up under WebMD or Drugs.com, both of which have large data bases to support their findings. @nurseruby hit the nail on the head.....one must advocate for themselves

Talk to your pharmacist. They know more about medications than doctors. Before I decide to take any new medication I google medication comparability.