Has anyone had serotonin syndrome?

[murfchurf]

I combined 100mg zoloft 50mg pristiq 40mg vyvanse and 2 bowls of weed but I had a strange reaction. I had these waves of numbness and tingling on the left side of my head, and I felt a pop on my scalp alongside a cold sensation. My left arm then went numb and I felt awful. Ever since I haven't felt the same and I feel like I have brain damage. I got an MRI and everything is OK.

 

[eve2004]

I am pretty sure I had it. Accidental OD of buproprion. I had clear mental status changes, visual distortions, weakness in my hand and arm (I tried to write a note with pen and paper and could not, I had trouble putting on a sweater or a tshirt). I think this happened twice. The first time, I was seeing objects that were distorted like in some 3D movie (the one with glasses) with neuro-muscular weakness. The second time, I was out for a walk in my neighbourhood and got lost and confused as time went on. When I found a main street near me, I had to keep repeating in my head the directions to get home. When I got to my door, I tried to open it with my key and just could not work the key for 5 minutes. Then I started have serious paranoia that someone would have known what kind of state I was in and I promptly got into bed to sleep it off....

The first time I went to the ER and they kept me all day including a stint at the psych ward and claimed it may have been "psychosis". In my non-professional opinion, both were serotonin syndrome.

I'm curious to see what other people's experience is with this and if they consulted medical professionals and whether or not it was formally diagnosed. I feel like this is overlooked or rarely ever considered.

 

[Lulzacruel]

If your looking for SS as a CTB method, then don't bother. Unless you mix so many drugs and never get found, you will survive the hospital visit. Only a 0.1% chance of death if i remember, ever lower than 1% of paracetamol overdose

 

[WantsToJumpAlready]

I am pretty sure I had it. Accidental OD of buproprion. I had clear mental status changes, visual distortions, weakness in my hand and arm (I tried to write a note with pen and paper and could not, I had trouble putting on a sweater or a tshirt). I think this happened twice. The first time, I was seeing objects that were distorted like in some 3D movie (the one with glasses) with neuro-muscular weakness. The second time, I was out for a walk in my neighbourhood and got lost and confused as time went on. When I found a main street near me, I had to keep repeating in my head the directions to get home. When I got to my door, I tried to open it with my key and just could not work the key for 5 minutes. Then I started have serious paranoia that someone would have known what kind of state I was in and I promptly got into bed to sleep it off....

The first time I went to the ER and they kept me all day including a stint at the psych ward and claimed it may have been "psychosis". In my non-professional opinion, both were serotonin syndrome.

I'm curious to see what other people's experience is with this and if they consulted medical professionals and whether or not it was formally diagnosed. I feel like this is overlooked or rarely ever considered.

I believe I've had serotonin syndrome that was also not recognized. My ADHD/ASD was misdiagnosed for Bipolar and Depression/Anxiety as a teenager and pretty much most of the SSRI's I was prescribed at the time made so sick, exactly like the symptoms you described. I was also hospitalized twice for psychosis once I started to try SSRI medication - I was also prescribed mood stabilizers in the mix too which made me so much worse, I was actually never even suicidal until I started taking mood stabilizers tbh

I no longer take any of those medications and after getting a proper ADHD diagnosis, the ADHD medication I take (while not 100% perfect) works so much better and the side effects are no where near is bad

But overall from you described, I definitely don't think it's out of the question to wonder if you actually had serotonin syndrome because I think I did too.

**And just a side note for anyone reading - if you take SSRI's and mood stabilizers and you find them helpful for you, please continue to take them. Everyone has different brain chemistry and meds work different on each individual - they definitely didn't work for me but they absolutely help other people.

 

[annointed_towers]

I am pretty sure I had it. Accidental OD of buproprion. I had clear mental status changes, visual distortions, weakness in my hand and arm (I tried to write a note with pen and paper and could not, I had trouble putting on a sweater or a tshirt). I think this happened twice. The first time, I was seeing objects that were distorted like in some 3D movie (the one with glasses) with neuro-muscular weakness. The second time, I was out for a walk in my neighbourhood and got lost and confused as time went on. When I found a main street near me, I had to keep repeating in my head the directions to get home. When I got to my door, I tried to open it with my key and just could not work the key for 5 minutes. Then I started have serious paranoia that someone would have known what kind of state I was in and I promptly got into bed to sleep it off....

The first time I went to the ER and they kept me all day including a stint at the psych ward and claimed it may have been "psychosis". In my non-professional opinion, both were serotonin syndrome.

I'm curious to see what other people's experience is with this and if they consulted medical professionals and whether or not it was formally diagnosed. I feel like this is overlooked or rarely ever considered.

I had this exact experience with bupropion and also OP's numbness in various body parts. I went to the ER and they said I was having a panic attack but I believe it was SS

 

[eve2004]

I had this exact experience with bupropion and also OP's numbness in various body parts. I went to the ER and they said I was having a panic attack but I believe it was SS

Yep, the ER originally thought I was having a panic attack until they spoke to my psychiatrist, then it was psychosis... Had they spoken to my pharmacist, perhaps they would have considered serotonin syndrome.

 

[murfchurf]

Yep, the ER originally thought I was having a panic attack until they spoke to my psychiatrist, then it was psychosis... Had they spoken to my pharmacist, perhaps they would have considered serotonin syndrome.

Wellbutrin doesn't act on serotonin so it couldn't have been serotonin syndrome.

 

[eve2004]

Wellbutrin doesn't act on serotonin so it couldn't have been serotonin syndrome.

Why Should an Emergency Physician Be Aware of This?

Although bupropion is not known to be directly serotonergic, it has been implicated as the single causative agent after overdose. This may be due to an indirect increase in activity of serotonergic cells. In these cases, bupropion overdose resulted in a clinical presentation consistent with serotonin syndrome, with the first having a temporal improvement after treatment with cyproheptadine. Physicians need to be aware of the potential serotonergic activity of bupropion for accurate assessment and treatment of this dangerous condition.

https://www.sciencedirect.com/science/article/abs/pii/S0736467920310878#:~:text=Although%20bupropion%20is%20not%20known,in%20activity%20of%20serotonergic%20cells.

My dose was already above the maximum daily dose, and I double dosed two days in a row. All the symptoms I had were exactly the same as serotonin syndrome. Serotonin is something the body produces anyway and when you take these meds that mess with neurotransmitters, you never know what will happen. Each body reacts differently so while MOST people may not have this reaction, some will. The fact that there are hundreds of meds that may or may not work and to varying degrees depending on the body also means that results certainly will vary if you over do it.

 

[eve2004]

Wellbutrin doesn't act on serotonin so it couldn't have been serotonin syndrome.

https://pdf.hres.ca/dpd_pm/00060991.PDF

The product monograph for Bupropion lists serotonin syndrome as an adverse effect of overdose which is what happened in my case. My regular dose was 600mg / day and I took 1200mg 2 days in a row. The maximum recommended dose is 450mg/day.

"Serotonin toxicity, also known as serotonin syndrome, is a potentially life-threatening condition and has been reported with bupropion in association with overdose. These cases include chronic administration at supratherapeutic doses (doses just above the maximum recommended daily dose, e.g. 600-800 mg)."

 

[sserafim]

I think I had serotonin syndrome last summer when I took my ADHD meds and drank 2 venti iced shaken espressos daily. I literally thought I was dying.

 

[wait.what]

I think I did a year or two ago. I didn't realize you shouldn't combine an SSRI with SAMe.

Turns out you shouldn't combine an SSRI with SAMe.

 

[Andro_USYD]

I've experienced seretonin syndrome twice or 3 times. Once I had it for an OD on Prozac while taking a few too many dexamphetamine. I felt really confused, my thoughts were all over the place and I was brought to hospital where my heartrate was a solid 130bpm. I also became psychotic on that much seretonin and was placed in a ward.

The second time I remember having it was years later (more recently), I combined LSD with the usual seretonin meds and ADHD meds and noticed I had the high heartrate, couldn't sleep and my thoughts once again we're starting to get more psychotic, I asked my dad if he could take me to hospital, which he did where they kept a watch on me. It's not a fun experience at all so I've been more careful with seretonin meds.

 

[Outsidelessness]

I am pretty sure I had it. Accidental OD of buproprion. I had clear mental status changes, visual distortions, weakness in my hand and arm (I tried to write a note with pen and paper and could not, I had trouble putting on a sweater or a tshirt). I think this happened twice. The first time, I was seeing objects that were distorted like in some 3D movie (the one with glasses) with neuro-muscular weakness. The second time, I was out for a walk in my neighbourhood and got lost and confused as time went on. When I found a main street near me, I had to keep repeating in my head the directions to get home. When I got to my door, I tried to open it with my key and just could not work the key for 5 minutes. Then I started have serious paranoia that someone would have known what kind of state I was in and I promptly got into bed to sleep it off....

The first time I went to the ER and they kept me all day including a stint at the psych ward and claimed it may have been "psychosis". In my non-professional opinion, both were serotonin syndrome.

I'm curious to see what other people's experience is with this and if they consulted medical professionals and whether or not it was formally diagnosed. I feel like this is overlooked or rarely ever considered.

That isn't serotonin syndrome, it's just too much bupropion. Too much dopamine and norepinephrine can definitely cause hallucinations and confusion, but bupropion isn't serotonergic. The most it'll ever do is induce serotonin as a metabolite and that's it, if I can recall. Serotonin syndrome is absolutely different compared to what you described.