serotonin syndrome

[braindead]

i am settled on 300mg of pregabalin, i was on 450 mg but i was spaced out, so i thought to try 600mg and i was away with space cadets, heading into serotonin syndrome land . i been the same with tramadol that screws you bad if on other meds

[hanshan]

Hi Braindead - What you describe doesn't sound like serotonin syndrome, but taking more pregabalin than you need can certainly make you feel spaced out (and interact with any other meds that you are take). It's best to stick with the dose that you feel comfortable with.

[panic_down_under]

i am settled on 300mg of pregabalin, i was on 450 mg but i was spaced out, so i thought to try 600mg and i was away with space cadets, heading into serotonin syndrome land

The earliest symptoms of serotonin syndrome (SS) are usually hypervigilance and agitation, the opposite of being 'spaced out.' But the two defining symptoms are clonus (https://en.wikipedia.org/wiki/Clonus) (Youtube vid (https://www.youtube.com/watch?v=UX75k8s5QUE)), particularly of the ankles (followed in severe cases by more generalised clonus and monoclonus (muscle twitching) then sometimes muscle rigidity) and a large spike in body temperature.

Much of the online "information" about SS is male bovine excreta, and that includes stuff propagated by doctors.

Not that pregabalin cannot cause SS as it has no direct effect on serotonin neurotransmission.

[braindead]

Hi Braindead - What you describe doesn't sound like serotonin syndrome, but taking more pregabalin than you need can certainly make you feel spaced out (and interact with any other meds that you are take). It's best to stick with the dose that you feel comfortable with.

thanks i found that out now, but i have had serotonin syndrome with tramadol and it felt the same

[panic_down_under]

thanks i found that out now, but i have had serotonin syndrome with tramadol and it felt the same

Tramadol is a serotonin releaser (and noradrenaline reuptake inhibitor) and so may trigger the syndrome when combined with other serotonergic meds, but not on its own, not even in massive, several thousand milligram overdoses (http://www.tandfonline.com/doi/full/10.3109/15563650.2015.1036279). The spaced out feeling would have been because it is a synthetic opiate structurally similar to codeine, not from SS.

[braindead]

Tramadol is a serotonin releaser (and noradrenaline reuptake inhibitor) and so may trigger the syndrome when combined with other serotonergic meds, but not on its own, not even in massive, several thousand milligram overdoses (http://www.tandfonline.com/doi/full/10.3109/15563650.2015.1036279). The spaced out feeling would have been because it is a synthetic opiate structurally similar to codeine, not from SS.

I was at the time taking 6mg lorazepam and 150 sertraline tramadol at a high dose made me fully loaded, i walked the full length of the ward naked so your theory is out the window .:shades:

[panic_down_under]

I was at the time taking 6mg lorazepam and 150 sertraline tramadol at a high dose made me fully loaded, i walked the full length of the ward naked so your theory is out the window .:shades:

It was most likely the benzodiazepine-tramadol combination, not serotonin syndrome. Addicts use BZDs (https://www.medpagetoday.com/special-reports/specialreports/44479) to potentiate opiate highs. Sadly, the combo also kills a lot of them.

[braindead]

It was most likely the benzodiazepine-tramadol combination, not serotonin syndrome. Addicts use BZDs (https://www.medpagetoday.com/special-reports/specialreports/44479) to potentiate opiate highs. Sadly, the combo also kills a lot of them.
what about the 150 mg sertraline /?/////////

[panic_down_under]

what about the 150 mg sertraline /?/////////

What about it? Whatever interaction there was between it and the tramadol appears to have been secondary to the benzodiazepine-tramadol combination. Also, benzodiazepines can reduce SS symptoms (http://www.sciencedirect.com/science/article/pii/S0197018602002139) to some extent.

You can find a detailed list of the symptoms of SS from the earliest manifestation of mild SS such as nausea, vomiting, nervousness, insomnia, headache, tremor, diarrhoea, dizziness and sweating right through to to the end stage in severe cases of hyperthermia here (http://www.psychotropical.com/the-clinical-picture) and there is also the Hunter Serotonin Toxicity Criteria (https://academic.oup.com/qjmed/article/96/9/635/1522590/The-Hunter-Serotonin-Toxicity-Criteria-simple-and), which is the internationally recognised SS diagnostic tool, summed up in this graphic (http://www.aafp.org/afp/2010/0501/afp20100501p1139-f1.gif).

Neither lists symptoms associated with being "spaced out" as a sign of SS. Which of the listed symptoms did you have?

[hanshan]

Hi Braindead - I'm pretty much with PDU here. Your symptoms are / were real, and may be a result of your meds (particularly at high doses or in combination), but what you describe doesn't match with serotonin syndrome. Serotonin is usually thought of as a "feel-good" neurotransmitter, but too much has a reverse effect - including agitation, high temperature, sweating, muscle contractions.

[braindead]

What about it? Whatever interaction there was between it and the tramadol appears to have been secondary to the benzodiazepine-tramadol combination. Also, benzodiazepines can reduce SS symptoms (http://www.sciencedirect.com/science/article/pii/S0197018602002139) to some extent.

You can find a detailed list of the symptoms of SS from the earliest manifestation of mild SS such as nausea, vomiting, nervousness, insomnia, headache, tremor, diarrhoea, dizziness and sweating right through to to the end stage in severe cases of hyperthermia here (http://www.psychotropical.com/the-clinical-picture) and there is also the Hunter Serotonin Toxicity Criteria (https://academic.oup.com/qjmed/article/96/9/635/1522590/The-Hunter-Serotonin-Toxicity-Criteria-simple-and), which is the internationally recognised SS diagnostic tool, summed up in this graphic (http://www.aafp.org/afp/2010/0501/afp20100501p1139-f1.gif).

Neither lists symptoms associated with being "spaced out" as a sign of SS. Which of the listed symptoms did you have?
seeing the train spotting baby on the ceiling, the walls were shivering has if cold/ striped of my operation gown. pulled out my catalpas even the 1 in my penis. and there is a small ballon that should be deflated i managed to pull that up my penis and out inflated .i then walked the full length of the ward and sidewards naked. i would say SWEATING ---DIZZINESS TREMOR NOT KNOWING A THING. 6MG OF ATIVAN I TAKE A DAY YOU WOULD BE UNCONCIOUS FOR A DAY. DONT QUESTION THE SEROTONIN TO ME TELL THE NURSE ON MED DUTY , i should never had tramadol if she had read the med list. THAT LIST NOW SAYS
NO TRAMADOL EVER, PLUS I WAS TAKING 12MG LORAZEPAM IN HOSPITAL. I HAD MY OWN MEDS, BUT FOR REASONS UNKNOWN THEY SAID THEY TO HAD A LIST, SPACE CADET BRIAN AND A GOOD LAUGH WAS HAD BY ALL STAFF AND PATIENTS, I WOKE AT BREAKFAST HAS ALWAYS HAS IF NOTHING HAD HAPPENED, MY PENIS WAS HURTING AND RATHER LARGE , I HAD MANY NURSES WANT TO CHECK IT OUT WITH A GLANCE, BRUISING ALL OVER MY ARMS FROM RIPPED OUT CAPITAS, I BECAME THE WARD STAR:shades:

---------- Post added at 09:13 ---------- Previous post was at 08:54 ----------

http://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1 you don't have to have all these symptoms but i had 2 thirds , why do you question it anyway. i told you the story i was near death from pancreatitis pipes in every hole after my op the worst being the drain pipe the remove that at 10 days when you body clings inside to it. the pull it fast it lifts you off the bed. that is the only pain i remember, and i had my gall bladder removed my bile tract repaired after they split it and a hernia just for luck 6 hours it took. it was supposed to be keyhole but the messed up has you see on my avatar

[hanshan]

Hi Braindead - When I first read "spaced out", I pictured someone dreamy and physically unresponsive, but what you describe above sounds like delirium and physical agitation. Whatever the underlying diagnosis, take care and do what you can to stay calm and healthy.

[braindead]

Hi Braindead - When I first read "spaced out", I pictured someone dreamy and physically unresponsive, but what you describe above sounds like delirium and physical agitation. Whatever the underlying diagnosis, take care and do what you can to stay calm and healthy.
life is hard from day 1 , hospitals and medication make it harder:shades:

[panic_down_under]

why do you question it anyway

Because I don't want someone reading this thread to think being 'spaced out" is a sign of serotonin syndrome, panic, and cold-turkey their antidepressant.

PS: And given this the pregabalin sub, it bears repeating that it cannot cause serotonin syndrome, either alone, or in combination with serotonergic meds including SSRIs, SNRIs, TCAs, MAOIs, or synthetic opiates.

[braindead]

Because I don't want someone reading this thread to think being 'spaced out" is a sign of serotonin syndrome, panic, and cold-turkey their antidepressant.

PS: And given this the pregabalin sub, it bears repeating that it cannot cause serotonin syndrome, either alone, or in combination with serotonergic meds including SSRIs, SNRIs, TCAs, MAOIs, or synthetic opiates.

IT WAS YEARS AGO i had never even heard of pregabalin i was on 150mg of sertraline and 6mg a day of lorazepam, and a because i had just come of morphine a very high dose of TRAMADOL. sorry if members cannot tell pregabalin from tramadol in my post