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Forum Name: Antidepressants

Question: Possibly suffering from Serotonin Syndrome & in need of


 twinkletwinklelittlestar - Sun Oct 31, 2004 12:34 am

I think I have been suffering from Serotonin Syndrome but none of my doctors have ever heard of this syndrome, though I have, and it's the only thing I can figure out that is wrong. I took Effexor 25 mg tablets for about a year off and on, Buspar probley all year, and started taking Nortriptyline 10-1-04. The reason the Effexor was taken off and on is because I had trouble with the side effects though it was the only effective medication that worked for my "past" depression. Past side effects was TMJ, facial muscle pain, severe tension headaches, lightheadness, blood pressure & pulse elevating, pounding pulse, nervousness, nausea, stomach pain, bladder pain and post fluid retention of my bladder. One time I got off of it cold turkey and went into severe depression and had a short-phased manic episode though I do not have Bipolar, ended up having to taper off of the medication. I've had other antidepressants I used before taking Effexor that caused me to feel more depressed and suicidal and I could not continue taking them. I am not depressed anymore but I have generalized anxiety disorder and still need the Buspar. It's been very effective in treating that and post tramatic stress. I took valiums for years for anxiety and insomnia and Soma short term for my back pain but ran out of them near the end of September and my doctor didn't want me taking them anymore so I had to quit. I had a new prescription filled Sept. 20th for the Effexor. When I started taking it, I started having stomach and bladder pain. Took it for 4 days and quit because the pain was so persistant and the problems subsided the next day but I had major trouble with getting my urine out when going to the bathroom, that lasted about 3 days. The following week, I started taking the Effexor again in hopes that those was just short term side effects. And three days later I ended up with a kidney infection with pain in my left kidney. Also ended up getting TMJ again, severe lighheadedness and nausea. Two days later, both of my kidney's was hurting. I did not think the Effexor was causing that, or I'd of quit using it. I've never even had a kidney infection before. I took Bactrim and after 2 days of finishing that, my infection was worse than the start with so I took another course of Bactrim. At this time, I am starting to have extremely painful spasms (?) in my kidneys and low back. The spasms later ended up going into my stomach organ and chest. And later into my esophagus, neck, face, upper back, arms and legs. Also went to having wavy movements in my skin like if a baby was inside of you kicking you and it caused my arms and legs to jerk. The spasms are a very painful lightning and squeezing pain and is very sharp, burning and cutting. It comes and goes and causes pain to get extremely severe, reminds me of a charley horse and hard labor contractions but worse. The wavy movements never hurt unless it hits me somewhere I'm already sore. I also got this burning pain inside my body which made me feel really warm on the outside. I quit taking all of my medications Oct 18th due to severe nausea. I ended up getting urinary retension (decrease to 6 ounces in 24 hours) and could not sleep. I'd sit up 3 nights straight and then go to sleep for only 3 hours, this became a continuous problem and I went to the ER. I was tested for stones but did not have any and my infection had supposedly cleared up. They did a CT scan which showed an ovarian cyst and some other abnormalites in my urinary tract. They gave me Lortab for pain which has helped some. The next week, the infection started coming back with showing a trace of infection. My doctor did a culture but it didn't show up any growth and he gave me Ambien to help me sleep but it didn't phase me. At this time, I was very talkative, very anxious and nervous but I think it was due to not having any sleep and my blood pressure was high, 147/90 and puse was 101. Normally it stays at 110 over 60 but has been elevated to high since I got so sick. A few days later, my urologist checked my urine and it showed a trace of protein, moderate amount of occult blood, 1+ leukocytes, moderate amount of bacteria, microscopic showed 10-15 leukocytes, 5-10 red blood cells and many epithelial cells. I told my urologist the situation and he said that Effexor is extremely harsh on the bladder but was unaware of Serotonin syndrome. This day, I went to experiencing uncontrollable problems with talking my thoughts out loud. He gave me Cipro for the infection and sent me over to the hospital for an ultrasound because of the ovarian cyst and enlarged uterus distended with fluid. It showed that I have a complex cystic lesion on my left ovary measuring 3.5 x 2.2 x 2.7 cm which has an appearance of endometrioma. A cystadenoma or cystadenocarcinoma remains within the differential diagnosis. I am now going to be sent to a gynecologist to make sure that I don't have ovarian cancer. The ultrasound also showed trace free fluid within the cul-de-sac and bowel loops noted within the pelvis. What does that mean? Last weekend, I had a major amount of exhaustion hit me and was able to get some sleep and that started continually improving and I've taken Ambien when needed and am sleeping really good now. The spasms improved also after sleeping better but I took a Buspar tonight after being off of it since 10-13 and it caused extremely bad spasms in my kidney's and lower to mid back. Also went to having very sharp shooting pains in my abdomen. These spasms were attacking my organs very frequently and seemed to be locating at the areas I've had past trouble with. I have GERD which I wasn't having any problems with before the spasms but my esophagus and neck got raw inside from it and I started belching alot and I think my stomach organ got inflammed, problems are persistant. Have taken Prevacid but it isn't of much help. Ephagastric region is extremley sore. I've had chronic pain in my back and it made it feel worse. I think my lower back is just hurting now because of the kidney inflammation or ovarian lesion. I had the spasms in my bladder and I have had cystitis for years but never encountered such a problem with it. It caused tenderness in my bladder and I now have constant pain in it also along with pelvic pain/pressure since last week. It caused pain and soreness in my left kidney that will not go away. I can only assume it is inflammed from the spasms and infection that I had for almost a month. Most of the left side of my abdomen (and going into my back) hurts really bad and is sore to the touch but my right side doesn't bother me. I've also had the spasms in the mid section of my abdomen and sometimes it felt like it was squeezing in my belly button. The spasms have been the worst and most painful in my left kidney and stomach organ. Lightheadness has improved, nausea is still really bad, had loss of appetite and some weight loss which has improved. Had been feeling down in the dumbs all day and easily cry so that's why I figured I needed to start taking the Buspar again but I think I must be allergic to antidepressants. My skin has been really itchy since but I haven't had any fever or rash which would more so concern me. So can you tell me what in the world is happening to me? Is this serotonin syndrome and if it is, how in the world am I going to get diagnosed with it when nobody around here has ever heard of it. And how long does it last? My doctor was in question to whether or not I've been having spasms because it is causing my organs to get very sore but I know that serotonin syndrome causes overreaction of the muscles. Could that be why the spasms are so bad? Normally spasms wouldn't cause that kind of problem. Can cancer also cause these type of spasms? I read in a forum earlier about a woman who has had bladder cancer for 2 months and is having painful spasms in her bladder and the pain is variating in intensity as mine has been. Is it possible to have spasms so severe, that it can cause inflammation? I have obviously gotten through the rough part of this syndrome, if that is what has been wrong, so will I be okay not being treated for it? Also am wondering what kind of severe problems and pain people encounter with cancer. And if there is any effective treatments for GAD and PTSD other than an antidepressant. Any information would be sincerly apprieciated. I have been so worried about this and lack of information is definetly not helping matters any. Thank you.
 Carolyn Merritt, LPN - Sun Oct 31, 2004 1:35 am

User avatar Hello:
I did some research on this syndrome and discovered it is more well known by pharmacists. According to J. Allen Scoggin, Pharm.D., MPA
Associate Professor of Pharmacy Practice and Pharmcoeconomics, at the University of Tennessee College of Pharmacy, "Serotonin syndrome is described in the literature as a potentially serious drug-related condition characterized by a number of mental, autonomic and neuromuscular changes. Although serotonin syndrome can cause death, the condition is mild in most persons, and with supportive care alone they tend to recover completely."

"Serotonin syndrome is most often reported in patients taking two or more medications that increase CNS serotonin levels by different mechanisms. The most common drug combinations associated with serotonin syndrome involve the MAOIs, selective serotonin reuptake inhibitors (SSRIs), and the tricyclic antidepressants."

Mild to moderately severe cases of serotonin syndrome usually resolve in 24 to 72 hours. Though most cases can be treated and resolve within a week

Mental status changes are the most frequently reported symptoms associated with serotonin syndrome. Other commonly reported features include motor abnormalities, cardiovascular changes, gastrointestinal problems and miscellaneous changes such as diaphoresis and fever

No specific therapeutic approach to the treatment of serotonin syndrome has been fully evaluated in the literature.

Initial treatment should consist of supportive measures aimed at reducing hypertension, tachycardia, hyperthermia and respiratory distress if these conditions are present.

Since it seems that it is the combination of two drugs that affect the serotonin levels it is imperative that whoever is treating you and prescribing your meds be aware of all the meds you are taking and how often you take them. When one gets medications from different doctors then you have a potential problem where you take meds from different doctors and can actually cause serious side effects. Its like mixing ammonia and bleach. Apart they are both good cleaners but together they cause a gas that is lethal.
I hope this helps you.
Regards,
Carolyn

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