Sarotonin Syndrome (not sure of spelling)

[karlin]

I am presently taking Zyban in order to assist me with quitting smoking.  However, I find it hard to sleep so I thought I would take St. John's Wort before bed to help me sleep and help with the depression that usually occurs with quitting smoking.  I have heard if you mix the two you could get Sarotonine Syndrome?  Could you explain to me what this syndrome is? and how taking these medicines would cause it? and what are the side effects of this syndrome?  Once you stop taking zyban and St. John Worts does the syndrome go away?

[Roger Gould, M.D.]

You cannot get serotonin syn. form these two meds,
zyban and st johns wort, as they have two different mechanisms of action.
zyban is actually wellbutrin an anti depressant in its own right. its
mechanism of action is primarily on dopamine, whereas st johns wort is
thought to be  on serotonin.  serotonin syn occurs ususally if one is on two
meds that are serotoninergic though it can occur on one alone. typical sxs
are dizziness, blood pressure instability, confusion. since you are
already on zyban, there is no need for another antidepressant. you
should avoid taking it at bedtime,since it may disturb sleep.

[Tachycardia]

this is a bit of a complicated one to answer!
you say your taking Zyban to quit smoking so im thinking your taking about 300mg a day?

now zyban is actually an anti-depressant in higher doses and is known by the name of Wellbutrin. it is not classed as an SSRI. MAOI, trycylic (or however u spell it!) etc.

St John's Wort is a herbal anti depressant, which exhibts traits of MAOI antidepressants and can also cause weight loss.

so if u look at this, u see u r actually combining 2 anti depressants, probably not in very high doses but...y'know!

serotonin syndrome occurs when there is too much serotonin in the body, so for example it occurs when mixing 2 drugs together that both releases serotonin in the brain i.e. the 2 your taking.

and st. johns has been known to cause serotonin syndrome, so my advice is carry on taking your Zyban, and NOT to combine it with any other anti-depressant(including st john) and anyother drug which releases serotonin from the brain.

if u cant sleep at night try some other sleeping aid, smoke some weed etc that'll harm u less than what ur doing now.

i cant remember if u asked but here are the 3 main symtons of serotonin syndrome:

1. changes in mental status: ie. hypomania, confusion, agitation.

2. Autonomic dysfunction : ie. diarrehea, fever, sweating, shivering

3. Neuromuscular abnormalities: ie. sudden brief muscle spasm, exagerrated reflexes, incoordination and clumsiness.

take care and good luck quitin smoking!

peace