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Re: Serotonin syndrome - Nardil + Stablon (tianept » Maxime

Posted by yxibow on February 9, 2006, at 0:24:35

In reply to Re: Serotonin syndrome - Nardil + Stablon (tianept, posted by Maxime on February 8, 2006, at 17:40:52

> Can serotonin really be fatal?
>
> Maxime

Serotonin Syndrome, not Serotonin itself, can be fatal, yes. It is also unpredictable. It is why multiple drugs that boost serotonin in the synapses of the brain should be combined carefully. It mimics some of the characteristics of NMS (Neuroleptic Malignant Syndrome).

It is usually characterized by at least the following symptoms: a very high temperature, agitation and confusion, and a variety of tremors and jerkiness.

Most cases resolve without further sequelae within 1 to two days with hospitcal care. Sometimes it is necessary to use serotonin antagonists, specifically cyproheptadine. Mild cases can be resolved with propranolol (this is why propranolol can cause depression in some people.) Benzodiazepines are sometimes used to control seizures and jerky motions.

Data from 1998 shows that over 27,000 SSRI exposures occurred, over 2600 major cases occurred, and 21 deaths happened.

These are quotes from emedicine.

It is a serious condition and should be immediately be reported to a doctor if multiple medications that have been prescribed have a probable cause for SS.

I have survived subclinical SS several times, because some drugs were made before we knew the knowledge of the P450 system. Robaxin happens to clash with one of my medications, probably Cymbalta. I felt slightly odd and had a subclinical fever (basically none.) So we adjusted it.

Its something to be aware of when taking SSRIs and then combining them with other medications.

But I wrote this up to clarify, not to scare people. Serious SS is still a rarity.

 

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