• N&PD Moderators: Skorpio | thegreenhand

Serotonin Syndrome from SSRI'S?

Johnny_bravo123

Greenlighter
Joined
Feb 18, 2016
Messages
4
Hi everyone.

First and foremost I'll introduce myself and my situation. I'm a 25 year old male from Sydney, Australia. I'll try not to make this too long, but I do want to accurately describe my experience and I'm hoping I can get some reassurance from this silly fear I have. So here we go.

During the middle of last year I had some difficult stuff happen in my life which basically manifested itself into anxiety/depression. This became quite severe. Rather than dealing with the problem head on, I decided to go to my doctor and get on an SSRI called Celexa. She had me on 20mg, and she also gave me some benzos to tie me over.

The reason for this post is to help me ease my anxieties about a specific fear I have. I basically read up on something know as serotonin syndrome on the internet so I decided to google it, but I found what I read vague and it really only reinforced the idea, so I decided to not google it again and try to forget about it. It mentioned that you can get mild versions of serotonin syndrome which is not noticeable, which I thought was kind of vague?

I was on the full dose of these SSRI's for only 12 days. During the first week that I was on the SSRI I didn't notice any change, I was pretty much the same. The benzo's at night time were of great relief, but because I was aware that they can be highly addictive I decided to stop them after week one. Well the day after I stopped the benzo's my anxiety was sky high, and the next three days were a relentless hell. I guess you could summarize it as extreme anxiety. Extreme fear, hand and feet sweats, my heart would sometimes race, I would get the shakes (not too severe, it was probably from all the adrenaline), thoughts racing, tinnitus, derealization/depersonalization, and I was only getting 3-4 hours sleep. My anxiety was already really bad before the meds, but this was next level shit and it was so bad that it actually made me cringe, life was hell. Amazingly I could still leave the house and I sometimes went out places with family. I was doing a fair bit of googling around this time about how to get off medication, and read a bunch of benzo withdrawal horror stories, so no doubt that reinforced everything. Now the funny thing is that after about 6pm my anxiety symptoms would fall away almost completely, and I would mostly be at peace for the evening. I would feel absolutely drained from it all, but I felt safe. I also responded to reassurance, so if I was reassured about my fears the anxiety would temporarily drop.

A few days after this all started I decided to take myself off the SSRI's with my doctors assistance. I wanted to address my anxiety on human terms. It was really easy getting off them, and I felt better for it knowing it was now left in the past. In fact after a week of being off them, the next month wasn't too bad. I still had the anxiety, but it was far less and I would experience moments of peace. I could feel happiness again and I was confident that I was getting back on track. I guess it's because I started to treat the actual anxiety properly that I saw improvements.

So where am I now? I'm definitely not in that horrendous spot I was in, and I can sleep eight hours a night with no worries, but I'm definitely not in a good spot either. I have all the tools I need to get over my anxiety, however I can feel the weight of this particular fear crushing me down and it would be nice to know that it is irrational so I can work more with the anxiety itself, instead of trying to work it all out in my mind. The fear itself is probably irrational but I thought I would post on here to get some opinions. My what if's basically revolve around 'what if I had serotonin syndrome and it's permanently damaged my brain'. Fun times indeed!

So yeah, that's why I'm posting. Is any one able to ease my bastard of a mind? I don't need a technical rundown or anything as unfortunately I'm not very savvy with the arts of neuroscience haha. Thanks.
 
Last edited:
SSRIs on their own don't really raise your serotonin levels to toxic amounts.
 
^Yes, SSRIs by themselves don't produce serotonin syndrome.

Serotonin syndrome is something that you either have or you don't. The most important criterea is clonus (rhythmic muscular contractions), and if you don't experience clonus then you don't have SS. There are other symptoms that can also occur during SS -- like hyperthermia -- but those other symptoms are nonspecific and they aren't useful diagnostic measures.

You can think about it like this: tiredness is a symptom of Valium overdose, but if you take 10 mg of Valium and get tired, then that doesn't mean you are experiencing symptoms of a minor Valium overdose. Likewise, if you take a serotonergic drug and get hot, you are not experiencing a minor case of serotonin syndrome.

SS is a severe illness and patients often die unless hospitalized. So seeing as you are OK, there is no reason for you to continue to worry about SS.
 
Last edited:
Thanks for the replies everyone. I thought it was unlikely that it was SS. If anything it was probably a bit of withdrawal from the Lorazepam. However I'm not familiar with rhythmic muscular contractions, what are they exactly?

I also have a question about benzos :) I was on 2-3mg of Ativan for around 7-8 days at the same time as the SSRI, probably took about 20mg all up. Do you know if this can cause any permanent issues, like damage to GABA receptors? And if not, how long would it take GABA levels to reach homeostasis? It was only 8 days so probably no worries there, just thought I'd check as I'm pretty sure 2-3mg is a high dose.
 
Thanks for the replies everyone. I thought it was unlikely that it was SS. If anything it was probably a bit of withdrawal from the Lorazepam. However I'm not familiar with rhythmic muscular contractions, what are they exactly?

I also have a question about benzos :) I was on 2-3mg of Ativan for around 7-8 days at the same time as the SSRI, probably took about 20mg all up. Do you know if this can cause any permanent issues, like damage to GABA receptors? And if not, how long would it take GABA levels to reach homeostasis? It was only 8 days so probably no worries there, just thought I'd check as I'm pretty sure 2-3mg is a high dose.

Clonus is a set of muscular contractions which are involuntary and recurring in a rhythmic manner.

Taking benzodiazepines for a short period like this does not affect GABA receptors to any noticeable degree as far as I know.
 
How can we distinguish between clonus caused by SS and muscle twitching during panic attack? Every time I have panic attack with muscle twitching I became scared this is SS clonus,because I am using SNRI.
 
How can we distinguish between clonus caused by SS and muscle twitching during panic attack? Every time I have panic attack with muscle twitching I became scared this is SS clonus,because I am using SNRI.

Clonus occurs as rhythmic contractions. SSRIs and SNRIs don't produce serotonin syndrome unless combined with another drug that effects the serotonin system. If you haven't taken anything else then there is no reason for you to be worrying about SS.

https://www.youtube.com/watch?v=4SrhgjGIZ30
 
I don't think I had that. If you have it during a panic attack then it's just the effects of adrenaline I guess. If SS does occur it is reversible yeah? Like it doesn't cause any permanent damage?

I totally shouldn't have googled again yesterday. I managed to convince myself that I'm going through benzo withdrawal again due to my very high anxiety, even though I haven't taken a single pill in three months, and had six weeks with only a low level of anxiety. Those horror stories are not healthy to read!
 
It's probably best I keep away from the internet actually. I don't want to read anything else that scares me haha, in a very fragile state right now. Adios and thanks for the replies!
 
Top