serotonin syndrome ?

[ellen/jane]

I have been on about 100 mg of Effexor for about 2 months now. Prior to that I had been on Prozac for some time.  I also take 50 mg of Trazadone at bedtime and 1 mg of Klonopin at bedtime.  I have noticed for the past few weeks that I have been severely EXHAUSTED for the past 2 1/2 weeks even though I get sufficient
sleep and don't seem terribly depressed.  I feel it as a real physical exhaustion.  My PCP did the usual battery of tests and the only the he came up with is slightly low testosterone (I am a 42 year old female).
I'm wondering if what I could be experiencing is the "Seretonin Syndrome".  THE SEROTONIN SYNDROME:

"The serotonin syndrome is a hypersotonergic state which is a very dangerous and a potentially fatal side effect of serotonergic enhancing drugs which can have multiple psychiatric and non-psychiatric symptoms."

Can you let me know if this may be a possibility ?  Thanks.

[Roger Gould, M.D.]

Of the three medications, only Effexor has a serotonin effect, and that dose is not an unusual dose.  I would think that its something else related to these medications....there are all cumulative....and can cause fatigue and a daily hangover.  If I were you I would start cutting down on each of them, or cutting out one of the sleep medications, to see what happens..

[LvdByGod!]

i disagree with the dr. you can have seratonin syndrom (syndrome) with trazadone too...check it out and do a google search on it..i recently stopped trazadone because i read of this possibility...i also take prozack...the two together can cause this...any two seratonin uptake inhibitors taken together can cause problems. read this you will have to cut and paste in address box on computer.

http://www.antidepressantsfacts.com/micromedex-serotonin-syndrome.htm

but, i have no idea if this is what your going through...

[Paule]

See the case report pasted below. One can get SS with just one agent, even at a low dose.  Considering the agents your on (enough to calm an elephant) and your symptoms, (you only complain of one symptom) it is unlikely you have S Syndrome.
Serotonin syndrome induced by low-dose venlafaxine.

Pan JJ, Shen WW.

Department of Psychiatry, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.

OBJECTIVE: To report the case of a patient with serotonin syndrome induced by low-dose venlafaxine. CASE SUMMARY: A 29-year-old Taiwanese woman with major depressive disorder abruptly developed serotonin syndrome during low-dose (37.5 mg/d) venlafaxine monotherapy, with symptoms of restlessness, tremor, shivering, diarrhea, vomiting, ataxia, tachycardia, and myoclonus. The patient recovered in 2 hours after receiving prochlorperazine and lorazepam in the emergency department. Venlafaxine was discontinued, and she was discharged home. Two weeks later, the patient started to receive fluoxetine 20 mg/d and reported no adverse adverse effects during follow-up clinic visits. DISCUSSION: The clinical manifestations of this case meet Sternbach's criteria of serotonin syndrome. Its possible etiologic factors include panic attack, adverse drug reaction, pharmacodynamic interaction, and congenital absence of CYP2D6 enzyme activity. The Naranjo probability scale suggested a probable causality of venlafaxine treatment and serotonin syndrome. CONCLUSIONS: Clinicians should be aware of the risk of serotonin syndrome when the patient receives not only a combination of 2 antidepressants, but also the single potent serotonergic agent venlafaxine.

[Paule]

You don't have to be taking two SSRI or SNRI agents in order to get S Syndrome...any drugs, foods that interfere with liver metabolism "may" cause problems but it is rare...the most common and not talked about drug/OTC drug interaction is Xanax and Prilosec.  Prilosec doubles or even triples the blood levels of alprazolam (xanax).  Very serious b/c Priolsec is sold otc now...

[desteny]

I am 25 years old female. I started having panic attacks back in 2002 finally got help in 2003 I took paxil cr 25 mg and Klonopin for 2 years had my life back no more panic attacks. Well since they took it off the market 2 months ago my Doctor started me on Effexor xr 75 mg 2 times a day. It didn't help me at all.. I would just sit and cry while on it. Then she started me on prozac 20 mg. I took it for about a week and felt worse then I have ever felt in my life. I had all the symptoms of seritonin syndrome which are changes in mental status, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, and tremor, coma death.. I stopped taking it.  If I can help anyone out there that's considering taking effexor xr or prozac please don't take it!. Theres so many things the FDA have covered up about this mediciation. After I did the research I think they should take those 2 anti depressents off the market not the Paxil cr that helped me get my life back.

[KittyMeghanLeah2]

Sounds like you are going through withdrawls of anti-depressant/anxiety medications.  Yes Effexor (SP) is dangerous, I was allergic to it, thankfully, and had to go to the ER for the steroid treatments before my throat really shut down from meds not anxiety!  I'm real mad at your doctor cuz I think they are put under pressure to try new medications and drugs on "patients" that have no problems with their current drugs.   Basically they end up making us human guiena pigs.  Hmmn, I hope you get to feeling better soon.  I know it's very painful and frustrating and feels like it will never end.  Maybe consider going back on the other meds that worked for you in the past?  Ok see a doctor I hope you find a good one.