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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by rainbowlight on May 13, 2002, at 17:03:17
I added Zoloft to my Lamictal/Remeron/Risperdal combo a little over a month ago. For the past two weeks I have been extremely fatigued/headaches/nauseau/stiff neck and back. I feel like I have a bad case of the flu, but it is not going away. I am wondering if it is Seratonin Syndrome since this seemed to start a few weeks after I added the Zoloft. Any advice or thoughts?
Posted by Ritch on May 13, 2002, at 22:46:11
In reply to Could I have Serotonin Syndrome? Advice please!, posted by rainbowlight on May 13, 2002, at 17:03:17
> I added Zoloft to my Lamictal/Remeron/Risperdal combo a little over a month ago. For the past two weeks I have been extremely fatigued/headaches/nauseau/stiff neck and back. I feel like I have a bad case of the flu, but it is not going away. I am wondering if it is Seratonin Syndrome since this seemed to start a few weeks after I added the Zoloft. Any advice or thoughts?
Hi,Well, right away I would tell your doctor about all of this stuff. Hey, don't even be too timid about an ER visit-at least that way it all gets documented and puts a little fire under your pdoc to get to the bottom of it. Geez, you are on a combo of high-power meds that hit a LOT of receptors. The stiff-neck/back could be EPS from the Risperdal. Headaches and nausea sound more like the serotonergic activity of the Zoloft (it gave me the worst nausea of any SSRI-except Luvox). However, you didn't mention feeling feverish or having a fever or getting disoriented and/or agitated, those are other common side effects of serotonin syndrome. What sounds a little spooky though is the fact that you are also on Lamictal. I wonder if the Zoloft addition could be boosting your lamotrigine blood levels up? Does this feel like a Lamictal dose increase? Hey, first thing-leave a message at your pdoc's, next, if you have any thoughts about going to the ER, just GO.
take care,
Mitch
Posted by rainbowlight on May 14, 2002, at 1:41:24
In reply to Re: Could I have Serotonin Syndrome? Advice please! » rainbowlight, posted by Ritch on May 13, 2002, at 22:46:11
I spoke with my pdoc. She thinks the level of Risperdal is raising in my system. She told me to take half my normal dose (which will be only 12.5 mgs.) for 5 days and than discontinue it. She also raised my Cogentin to get rid of the stiff neck. I was suspecting that it was the Zoloft, but she doesn't think I am at high enough levels to be having a serotonin problem. (I take 30 mgs. Remeron, 100 mgs. Lamictal, and 37.5 mgs. Zoloft). I have never had a Lamictal increase, I started at 50 and went up to 100 a few days later (scary huh?!). I am not feeling agitated or disoriented like you mentioned. I pretty much feel like I have the flu, no mental symptoms at all. It's driving me nuts!
Posted by Ritch on May 14, 2002, at 10:15:37
In reply to Ritch, thanks for answering, more...., posted by rainbowlight on May 14, 2002, at 1:41:24
> I spoke with my pdoc. She thinks the level of Risperdal is raising in my system. She told me to take half my normal dose (which will be only 12.5 mgs.) for 5 days and than discontinue it. She also raised my Cogentin to get rid of the stiff neck. I was suspecting that it was the Zoloft, but she doesn't think I am at high enough levels to be having a serotonin problem. (I take 30 mgs. Remeron, 100 mgs. Lamictal, and 37.5 mgs. Zoloft). I have never had a Lamictal increase, I started at 50 and went up to 100 a few days later (scary huh?!). I am not feeling agitated or disoriented like you mentioned. I pretty much feel like I have the flu, no mental symptoms at all. It's driving me nuts!
Yep,It probably was the Risperdal. Stiff neck/back are pretty classic EPS symptoms on AP's. So, you are discontinuing the Risperdal? The dose you listed seems kind of high there--do you mean 1.25mg (Risperdal) instead? The "flu thing" really sounds like the Zoloft, though. That might pass with your body becoming adjusted to it. So, you have also been taking Cogentin to offset the EPS from the Risperdal? The sfx of the Cogentin could be adding in with the Zoloft, too. I assume that you will withdraw the Cogentin after you have withdrawn the Risperdal?
Mitch
Posted by rainbowlight on May 14, 2002, at 18:46:19
In reply to Re: Ritch, thanks for answering, more.... » rainbowlight, posted by Ritch on May 14, 2002, at 10:15:37
LOL! You're right, the amount of risperdal I am taking now is 0.125 (I think that's right, half of a .25 tablet). Yes, I will get rid of the Cogentin with the Risperdal. But ya know, I think it is the Zoloft making me sick. I noticed after I took it this morning is when I started to feel real fluish and queezie. Is this normal? I wonder if it will go away in time? Maybe I should be taking it at night? Gosh, I really want this Zoloft to work out. Any suggestions. (Right now I take the Remeron/Lamictal/Risperdal/Cogentin and Restoril at night, and the Lamictal again in the morning). Thanks for all your advice!
Posted by Ritch on May 14, 2002, at 22:18:05
In reply to Ritch (Mitch) more question for ya!, posted by rainbowlight on May 14, 2002, at 18:46:19
> LOL! You're right, the amount of risperdal I am taking now is 0.125 (I think that's right, half of a .25 tablet). Yes, I will get rid of the Cogentin with the Risperdal. But ya know, I think it is the Zoloft making me sick. I noticed after I took it this morning is when I started to feel real fluish and queezie. Is this normal? I wonder if it will go away in time? Maybe I should be taking it at night? Gosh, I really want this Zoloft to work out. Any suggestions. (Right now I take the Remeron/Lamictal/Risperdal/Cogentin and Restoril at night, and the Lamictal again in the morning). Thanks for all your advice!
No problema!,Yes, Zoloft can be very nauseating. Yes, try it at nighttime. I took Zoloft off and on for several years and had insomnia probs/restless legs, daytime nausea postdose etc. and then duh! finally realized that if I took it at bedtime I slept better and skipped the experience of the first few most nauseating hours right after you take it. You might also back off the Zoloft dose to just 25mg bedtime until you get weened off the Risperdal/Cogentin duo.
Posted by rainbowlight on May 14, 2002, at 22:54:28
In reply to Re: Ritch (Mitch) more question for ya! » rainbowlight, posted by Ritch on May 14, 2002, at 22:18:05
I am going to try to take it at night time tonight, and just 25 mgs. I sure hope I feel better soon. I'm getting concerned that I might be getting some time of Serotonin problem. Thanks again
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