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 (Youtube vid), 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. 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. 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 .

[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 .

It was most likely the benzodiazepine-tramadol combination, not serotonin syndrome. Addicts use BZDs 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 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 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 and there is also the Hunter Serotonin Toxicity Criteria, which is the internationally recognised SS diagnostic tool, summed up in this graphic.

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.