Posted by ed_uk on November 8, 2004, at 12:35:46
In reply to Re: The Forbidden Combination, posted by Squiggles on November 8, 2004, at 11:38:06
Squiggles, I will provide you with the source. I am also I layman, I never claimed to be anything but :-)
The information was from Stockley's drug interactions online. There is no page number. I have the latest edition of the textbook at home but I don't have it with me.
Stockley's goes on to say.....'The symptoms seen appear to be consistent with the serotonin-syndrome which is typified by CNS irritability, increased muscle tone, shivering, altered consciousness and myoclonus.'
The serotonin syndrome can be thought of both as an adverse effect and an as a drug interaction. It has occasionally been reported in patients given SSRIs *alone* as well as in people given venlafaxine alone. It has also been reported to occur in patients receiving a wide variety of different drug combinations.
The serotonin syndrome occurs on a spectrum. It can be mild, moderate or it can be severe. Severe SS has often been seen in people who have received an MAOI plus a serotonin reuptake inhibitor.
Here is some information about the symptoms which may occur in the SS...
Am J Psychiatry. 1991 Jun;148(6):705-13.
The serotonin syndrome.
Sternbach H.
Department of Psychiatry, UCLA-Neuropsychiatric Institute, Los Angeles.
OBJECTIVE AND METHOD: A review of the literature on the serotonin syndrome in animals and human beings was conducted, and 12 reports of 38 cases in human patients were then analyzed to determine the most frequently reported clinical features and drug interactions, as well as the incidence, treatment, and outcome of this syndrome. FINDINGS: The serotonin syndrome is most commonly the result of the interaction between serotonergic agents and monoamine oxidase inhibitors. The most frequent clinical features are changes in mental status, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, and tremor. The presumed pathophysiological mechanism involves brainstem and spinal cord activation of the 1A form of serotonin (5-hydroxytryptamine, or 5-HT) receptor. The incidence of the syndrome is not known. Both sexes have been affected, and patients' ages have ranged from 20 to 68 years. Discontinuation of the suspected serotonergic agent and institution of supportive measures are the primary treatment, although 5-HT receptor antagonists may also play a role. Once treatment is instituted, the syndrome typically resolves within 24 hours, but confusion can last for days, and death has been reported. CONCLUSIONS: The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment. Further work is needed to establish the diagnostic criteria, incidence, and predisposing factors, to identify the role of 5-HT antagonists in treatment, and to differentiate the syndrome from neuroleptic malignant syndrome.
Ed
poster:ed_uk
thread:413243
URL: http://www.dr-bob.org/babble/20041108/msgs/413304.html