Serotonin Syndrome - Long Term Prognosis

Hello,

I am a chronic pain patient who was treated at a reputable hospital in California.  I was given amitryptaline to sleep at night, and Lexapro to help me with depression. Immiediately starting the treatment, my legs became numb when I walked up stairs. I thought I had buldged a disc so my pain doc sent me to physical therapy. I started having muscle twitching, mood disturbances, gi disturbances, weakness when climbing stairs, and mild balance issues- doc said I had pain syndrome and was becoming overly fixated on sensations.  By the time my head started involuntarily twitching and I was noticing shortness of breath doing activites that were easy two weeks before (this is two months after the dual anti-depressant treatment began), I stopped the medication and went to go see an internist. My internist says I was suffering from a slowly progressing Serotonin Syndrome. 2 weeks after stopping the medication, none of my symptoms have resolved.

My question for you is - Do you think these symptoms will resolve, and what can I do expedite the process? I'm having difficultly staying calm (which I know is key) as my mood has been significantly changed and I am very anxious and depressed.

[JainMD]

Hi Nicole,
Your symptoms indeed sound like serotonin syndrome.
You were on drugs which cause concentration of serotonin to rise.
In mild cases, removal of drug for more than 72 hours resolves the symptomatology.
The symptoms in your case do not appear to be mild.
I think you need to contact your psychiatrist back and get admitted in hospital for day or two till symptoms are subsided.
Benzodiazepines can be started for myoclonus.
If symptoms still persists cyproheptadine, propranolol, or methysergide can be started then.
Once admitted to hospital immediate supportive care as necessary (e.g., therapy for hypertension, tachycardia, hyperthermia, respiratory distress) can be provided.
Keep me informed about your symptom progression.
Bye.