Preventing Seretonin Syndrome ?

[Altered Perception]

Serotonin syndrome is a potentially life-threatening drug reaction that may occur following inadvertent interactions between drugs.

Apparently one of the most common treatment for Seretonin Syndrome is "Cyproheptadine hydrochloride" (Periactin) which works by blocking Seretonin but it is also a commonly available antihistamine.

My question is if someone was to take two substances known to cause Seretonin Syndrome for example Methamphetamine with Tramadol can you take a precautionary dose of "Cyproheptadine hydrochloride" to prevent the occurrence of Seretonin Syndrome prior to dosing? And is it guaranteed to prevent against a fatal interaction?

 

[Tyrielle]

Interesting thought.
I use to mix meth and seroquil and I've heard that fucks people up to not sure if its this serotonin syndrome thou?

 

[JCRG]

Serotonin syndrome is a potentially life-threatening drug reaction that may occur following inadvertent interactions between drugs.

Apparently one of the most common treatment for Seretonin Syndrome is "Cyproheptadine hydrochloride" (Periactin) which works by blocking Seretonin but it is also a commonly available antihistamine.

My question is if someone was to take two substances known to cause Seretonin Syndrome for example Methamphetamine with Tramadol can you take a precautionary dose of "Cyproheptadine hydrochloride" to prevent the occurrence of Seretonin Syndrome prior to dosing? And is it guaranteed to prevent against a fatal interaction?

Both Amphetamines and Tramadol are metabolized by the CYP2D6 cytochrome, thus not only the mechanism of action increases the likelihood of serotonin syndrome, but also the fact that both will have augmented plasma concentrations and half-life because of said coincidence. Furthermore, cyproheptadine is also metabolised in the liver (not sure if by/which cytochrome), further increasing the chaotic interactions.

Also bear in mind that cyproheptadine, being an antihistamine with anti-serotoninergic properties, would cause drowsiness, sedation, etc.; effects that would negate the stimulant properties of amphetamines, thus making the consumption of said substance pretty much pointless.

Y'see, pharmacology is not like algebra, adding/substracting substances, and even doing so at different times, may yield extremely different results.

My advice would be to save the cyproheptadine and use it IF the serotonin syndrome begins to manifest.

 

[Altered Perception]

effects that would negate the stimulant properties of amphetamines, thus making the consumption of said substance pretty much pointless.
My advice would be to save the cyproheptadine and use it IF the serotonin syndrome begins to manifest.

Thank you for your reply.

Many online discussions state that you should wait up to a week before taking meth after tramadol to avoid seretonin syndrome. But for example lets say if I took meth in the morning and then at night I wanted to take tramadol to go to sleep and i was no longer interested in prolonging the "stimulant properties of amphetamines" but I also wanted to be safe in regards to seretonin syndrome then if I was to add a very small dose of cyproheptadine to the equation would it ensure my safety?

I repeat the question because I feel your initial response was influenced by your statement that cyproheptadine "effects that would negate the stimulant properties of amphetamines, thus making the consumption of said substance pretty much pointless.

 

[Altered Perception]

Bump - still seeking a response

 

[TheLostBoys]

You say you wanted to take Tramadol to go to sleep? For me, that would be impossible because Tramadol is like speed for me.......it keeps me up all night & it shouldn't be mixed with MDMA or anything with the sort.

If you want to fall a sleep, take some Valium.........

 

[Thorns Have Roses]

Wouldn't seizures be a worry with the meth-tramadol combo, quite apart from any SS concerns?

can you take a precautionary dose of "Cyproheptadine hydrochloride" to prevent the occurrence of Seretonin Syndrome prior to dosing?

From what I've read¹, not everyone responds to cyproheptadine. So even if it worked for some people, you couldn't assume that it would work for you.

You could forget the tramadol and just try a sedating antihistamine to help you sleep. Insomnia may become less of an issue as tolerance develops.

 

[Altered Perception]

Thanks for the reply guys but I now regret having used tramadol and meth as an example. That was just one example, Because I have a lot of OTHER medications that can cause Seretonin Syndrome when combined so so lets just forget about the tramadol and Meth combo I just wanted to know if taking cyproheptadine would prevent complications before they occur.

So far the comment from Never Knows Best about "not everyone responds to cyproheptadine" has been most useful. But I would like to hear more