Serotonin Syndrome vs NMS

[flatline]

Hey guys. Currently recovering from a bad reaction to haldol and was wondering your opinions.

here's a timeline for anyone confused:

tuesday - around 1am go to the ER for unknown headache fatigue and neck pain. I was given a shot of haloperidol to treat it. around 20 minutes later I start having an extremely bad reaction

I feel like I always have to keep moving, I was thrashing in the bed I was in, all these things. Ended up pacing the hallway as I tried not to pass out. me and the two other nurses decided that it was most likely a panic attack triggered by me looking up drug interactions

so they let me go. About an hour later I'm lying in bed trying to go to sleep and I still can't with all the Tremors and shit. I go back again and they give me lorazepam and Cogentin, which does help with my thrashing and twitching immensely. I get discharged

wake up the next day around 6 or so, feeling okay but still a bit shaken up and groggy from my legs being on fire so much. Take my Sertraline like normal, about 20 minutes later I have the same symptoms come on again. go back to the ER, get some blood tests done

by the time I went back in my pulse was 140 and my blood pressure was like 140 over 105. So serious ****ing numbers. I had to wait in the waiting room for like an hour and a half to get a room

I finally get a room, the doctor ordered some more tests and does a physical, and He suggests to keep me overnight for observation and then this is where my memory gets a bit fuzzy as to what actually happened when

okay so it looks at like 3 a. m. I got a sandwich for dinner. this is where I started losing memory because I was just tired and dozing off so much but eventually I wake up and find out they actually took some more blood in my sleep

the test they were looking at specifically, ck blood, is one of the indicators they use for serotonin syndrome although it's not a complete diagnosis if it's high. The one they took when I was just in the ER was like 650 and the one they got while I was sleeping was about 400. normal range is about 200

so I get some crappy chicken and rice from the hospital restaurant (they had spaghetti and pizza and shit it was kind of crazy) and promptly passed out again. I woke up at like 4: 30 I think and my phone was dead this entire time otherwise I would have been shitposting

and so I got discharged around 5: 30. The plan was to go back to smash club and just chill out, but I noticed my heart rate was still pretty high (120s) so I went back to the ER. they didn't see much cause for alarm but they did some more blood tests to rule out anything else

nothing seemed alarming so here I am back at home. I don't feel too sick or anything, but I do feel a bit hot and groggy. just trying to relax and taking my temperature occasionally x)

I think they should have kept me in the hospital for another day TBH but I'm going to call the ER people and see which thing exactly I should be worried about and what I should do from here

that ER call left me with a few more questions than answers. basically she just told me to follow up with my primary doctor tomorrow and call and see what they think about it. if it was NLS then I need to watch out for muscle stiffness and a fever, like a very high fever

which is one of the worst things to tell me in terms of watch and wait because I will be always on the watch, but this is a relatively rare side effect in the first place so hopefully it doesn't end up happening. The question I have is what even happened in the first place??

Sorry for TL. Just couldn't simplify any more. All this on my birthday, too x.x

[ankietyjoe]

One question, why were you given an anti-psychotic for a headache?

Everything else you described sounds exactly like a bad panic attack. It's happened to me (almost word for word) a few times in the past, and nothing was ever found to be 'wrong'.

When I had bad ones like that they were usually triggered by some kind of stressor. Once it was a big workout, another time it was a virus and then going back to work too fast and another time was taking painkillers that contained caffeine that I didn't know about.

I would focus on just letting the experience pass.

[flatline]

Apparently it helps with headaches. They had been prescribing it to a lot of people there recently.

I definitely feel like panic was a part of it but based on my CK tests in particular there was something going down, I'm just confused as to what. I had panic attacks a couple months ago but they were mostly controlled once I started going on Sertraline, and this felt kind of like it, but lasting for hours upon hours no matter what i did (in fact, taking my amitriptyline probably made it worse). The official diagnosis out of the Short-Term Stay (inpatient) department was serotonin syndrome

[ankietyjoe]

Aspirin helps with headaches too.

I'm just staggered they are giving you such powerful medication for pain. It doesn't make sense to me (but then again, I'm not a Doctor...). They then give you a benzo and another drug that looks like it's to counteract the reactions from the first drug?!

The thing about these pills is that they can and do have side effects, especially with somebody already suffering with anxiety.

120-140bpm heart rates are 'fine' for somebody in your situation at that time. I've been kept in hospital a couple of times with persistent tachycardia and nothing was found to be wrong. Just anxiety/stress.

I would go back and find out exactly why you were given those drugs in the first place. If you're already on anti-depressants (I'm not entirely sure from the information in your post) then it's entirely possible that an interaction did happen, but again....I'm not Doctor.

[flatline]

lorazepam to calm me down, cogentin reverses the side effects of the haldol. i had toridol alongside the haldol, and benadryl. in hindsight yeah that's a lot of drugs, i would have been fine with the toridol and nothing else but I guess that's the ER for you?

the lorazepam did help the tremors a lot though

now i've been just feeling super dizzy and lethargic and junk

[ankietyjoe]

When my anxiety was bad, a glass of diet coke could send me into the stratosphere for hours. Your body will perceive almost anything as 'an issue' when you're in an already anxious state.

I think your body has just reacted to a potent concoction of chemicals and seen it as a threat.

Some days I couldn't even eat salty food because of the following spike in blood pressure.

[flatline]

I do remember the initial reaction taking place when I looked up the drug I had been taken and it mentioned a serious risk of combining it with my Sertraline and amitriptyline (it didn't end up being the right drug in the first place although Haldol still has pretty bad reactions with those two). That's what made me think it was a panic attack, but it was far stronger than any I've ever had in the past, and I've had some pretty strong ones

regardless. At this point most of those drugs have been flushed out of my system so any side effects should be gone? Besides nms which is obviously the scariest one...

also yeah, I was on 100 mg Sertraline and 10 mg amitriptyline but those were discontinued after this

my legs feel really heavy too. I should probably get some sleep. it feels like gravity is 2 times its normal strength on me

[flatline]

I finally have a name to put towards that ridiculous feeling of restlessness: akathisia. it wasn't a panic attack, although me panicking over this feeling of complete restlessness probably made it worse.

[flatline]

but it's mostly gone, even though one shot of Haldol can give you akathisia for up to 6 months. I'm just really having dizzy spells now, especially when I like bend my knees and crouched down. It feels like my brain is lagging behind my body - anyone know what I'm talking about?

[flatline]

come to think of it, I don't even know how I would have gotten serotonin syndrome in the first place. I had been on that combination of ssris for like a month and a half without any negative effects. So maybe I already got nms and I'm just through with it? I honestly have no idea