Seritonin Syndrome

[JKJ]

I get my medical care at the Dayton VA hospital.  An RN there prescribed me both Wellbutrin (Buspar) and Trazodone.  Come to find out, that's a HUGE no-no.  The drug interaction between those two causes serotonin syndrome.  I found out too late.  I've been sick the past several days with it.  It's horrid.  I'm now self-tapering down my Wellbutrin.

The RN that I used to see was promoted a couple of months ago to a position where she no longer sees pts---gee I wonder why??? (Yes, the VA allows RNs to prescribe meds).  As of now I don't have a new pdoc yet so I have no one to call about my meds--I'm on my own.

I checked this syndrome on the computer and looked up the symptoms and OMG...I was answering yes right down the list.  Scary ****.  

So don't take these two meds together, but I'm sure most of you out there have competent, civilian docs.  The VA really needs some.

[JKJ]

This is from the website drugs.com/drug interactions.  It specifically mentions serotonin syndrome.


BuSpar (busPIRone) and traZODONE (Major Drug-Drug)

MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and 5-hydroxytryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors.

MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for the development of serotonin syndrome, which may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. Particular caution is advised when increasing the dosages of these agents. The potential risk of serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is recommended following use of fluoxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

[Hensley258]

That's strange, I've never heard of Welbutrin contributing to Serotonin Syndrome. It's a Doapamine Reuptake Inhibitor and has almost no effect on the neurotransmitter Serotonin.

Trazadone is a Tetra-Cyclic antidepressant that effects Serotonin and Buspar is simply an anti-anxiety medication that has never been associated with producing Srotonin Syndrome.

I fail to see how this three med combination could cause SS. In fact that's not an uncommon three med cobination and should be safe at proper dosages.