Terrified of serotonin syndrome

[Chrysoprase]

This is a tough one and it’s really kicking my butt.

My doctor suggested I try Paxil for my anxiety, and started me off on just 10mg. Unfortunately I’ve yet to be able to make myself take it, because I’m terrified of serotonin syndrome. I know I need the Paxil to get beyond these irrational anxiety attacks, but I just can’t take that first step.

Some years ago I took Benadryl while on Citalopram and had a really frightening experience with my blood pressure and heart rate dropping low. I was fine in the end but the scare has made me so afraid to take anti-depressants again.

Just wondering if anyone has any suggestions for how to push past this fear and start taking the medication so I can begin to really combat the health anxiety. I know logically that I need to.

[nomorepanic]

Hi

This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

Please also read this post:

http://www.nomorepanic.co.uk/showthread.php?t=213239

[panic_down_under]

I’m terrified of serotonin syndrome

You cannot develop serotonin syndrome, aka serotonin toxicity, from taking a single serotonergic drug, and it is rare even with multiple drugs. Very few doctors have ever seen a genuine case. 99.999% of what you find when consulting Dr Google are male bovine excreta. One of the two leading experts on SS/T, Ken Gillman, spends much of his time correcting the nonsense written about it in medical journals.

Most true cases involve MAOI antidepressants, plus another serotonergic med.

Some years ago I took Benadryl while on Citalopram and had a really frightening experience with my blood pressure and heart rate dropping low

Was that confirmed by a doctor, or what you perceived happened?

Benadryl (*diphenhydramine) is often suggested as a mild hypnotic to counter SSRI induced insomnia and there are rarely any issues with the combination apart from the usual diphenhydramine side-effects of sedation and dizziness typical of antihistamines.

*Note: This is the main ingredient in Benadryl sold in the U.S. It may contain another antihistamine in other countries, including the UK.

[Chrysoprase]

Thank you for the information about serotonin syndrome. To be honest in this case I didn’t check google (surprisingly) but instead been told horror stories by various people when I told them I was starting Paxil. (“Well I heard about someone who...” stories.)

Of course the logic part of my mind knows better than to listen to those too, but getting the anxiety under control has been rough.

Was that confirmed by a doctor, or what you perceived happened?

All I know is that my heart rate and blood pressure both dropped below what’s normal for me—I checked both at the time and that was what I found. When I reported it to my doctor at the time he called it a “bad reaction.” That was several years ago and in another town, and I didn’t think to ask for any clarification on what he meant then.

Again I really appreciate your facts and information! Nothing helps anxiety like listening to solid facts. And I was able to take the Paxil today, which is a start!

[panic_down_under]

And I was able to take the Paxil today, which is a start!

Antidepressants can trigger a range of unpleasant side-effects at the beginning, but they rarely do any physical harm when taken as directed and this is especially true of most SSRIs and SNRIs, even in very large overdoses.

Just to satisfy my curiosity, why have you/your doctor chosen Paxil (paroxetine) this time and not citalopram?

[Chrysoprase]

Just to satisfy my curiosity, why have you/your doctor chosen Paxil (paroxetine) this time and not citalopram?

I really disliked how I felt on citalopram—like a zombie, could barely enjoy anything—even after trying several dosages over the time I took it. I was on it for a few years but I finally gave up on it because of how miserable I felt with it.

[panic_down_under]

I really disliked how I felt on citalopram—like a zombie, could barely enjoy anything.

Thanks. Yeah, this can happen with any AD. Unfortunately, despite decades of trying no one has yet come up with a method for determining which med is likely to be the best fit with a person's physiology. It still comes down to trial and error. Fingers crossed that you have better success with Paxil.

[Chrysoprase]

Meant to say this sooner but thanks again for your help in calming my irrational fear. Have taken the Paxil a few days now, obviously too early to tell how it will affect me but I’m feeling a lot more comfortable about trying it and appreciate your help a lot!

[panic_down_under]

Meant to say this sooner but thanks again for your help in calming my irrational fear. Have taken the Paxil a few days now, obviously too early to tell how it will affect me but I’m feeling a lot more comfortable about trying it and appreciate your help a lot!

Cool, all part of the service. The invoice is in the mail. Thanks!

Not to rain on the parade, however, it is still early days for you and Paxil. You might be lucky and just sail through wondering what all the fuss was about, but the more likely scenario is that you'll have a bad day, or three, from time to time. If this happens just keep reminding yourself that none of it means anything and that the result will be worth it. It almost always is.