Why have I been suffering for > a year? Serotonin syndrome?

[Franco87]

Dear BL community,

Greetings from Spain. Ever since an incident pretty much one, long year ago I haven't been the same person; and I simply don't understand what it is that might have happened to me. Which means that I don't know what to do about it.

The following is what the ingestion of psychoactive substances looked like during the day when it all started:

- 1000 am: 200 mg of slow-release 5-HTP (which I have successfully taken - for years - against my social and performance/work anxiety)
- 0730 pm: 25 mg of sceletium tortuosum (kanna) which I occasionally add to the 5HTP for increased anxyolitic and euphoric effects
- From 0800 pm to 0300 am of the following morning: a decent but not ridiculous volume of alcohol including beers over dinner, and then later at night, a couple of long drinks in the club
- From 0100 to 0300 am: 3-4 lines average-sized lines of what I thought was cocaine (no more than 0.5 gram). It was bought off the street so chances are that not a lot of cocaine was in there. My best guess is that the main psychoactive ingredient was some kind of amphetamine.

Problem:

Initially the coke high seemed to be less strong / euphoric than usual, and also shorter; the come-down from each line came very quickly. 20 mins after the 3rd or 4th line at some point I felt like 'collapsed' / tired / uncoordinated / confused / super-drunk so I decided to go home. I slept fairly well despite waking up at some point with strong tachycardia (and sweating I think), but managed to fall back to sleep again. The next day is when all started. I felt extremely drowsy, dizzy, unable to think clearly, difficulties to find words while speaking, vision problems (blurred vision or so) etc. The first week I could sleep fairly normal, but then in the second week after, a bout of insomnia started that I have never had in my life before, probably boosted by the worries about what was going on with me.

While over time the insomnia fully, and the vision problems, partly, improved, I am left with the following constant symptoms:

- Strong brain-fog / cognitive impairment, meaning strong difficulties in thinking clearly, concentrating, reading and writing; to the extent that I have had to go on a 2-month sick leave from my job because it is very intellectually demanding
- Pressure around the head that comes and goes, and reappears at shifting locations
- A feeling of tingling and numbness in my left foot and hand that comes and goes
- I think what might be called anhedonia - lost of interest in once pleasurable activities - which, however, I fully ascribe to the previously mentioned symptoms, particularly the first one
- Ongoing worry about what might have happened to me; which, however, I consider to be the result of the previously mentioned symptoms; and not - from my subjective perspective at least - their cause, (this does NOT feel, at all, like the anxiety I used to have in the past - it seems to me I am now actually less anxious, less alive, kind of broken, than before! It's a deeper, more existential worry.

So what could have happened?

- Serotonin syndrome? I don't remember being feverish, nor hallucinating, nor convulsing, nor vomiting, nor having diarrhea. I remember being in some kind of very awkward stupor though, followed - after going to bed and falling asleep - by tachycardia and sweating. And having a debilitating headache the next day.
- It's all in my head, results from worry, and leads to 'pseudo-neurological', cognitive symptoms that lead to more worry?

I should say that this started a few weeks before the birth of my first child (that night out was meant to be the celebration of that!). Meaning that stress levels, even if only subconsciously, surely were high (consciously though, I was pretty relaxed, at least before the incident). It was also quite traumatic, I have to say, having to experience the ensuing birth of my kiddo in this kind of mind-set / cognition!

I have been exercising a lot; eating healthily; have stopped the intake of 5HTP and Kanna; have been meditating; have been seeing a psychologist. Nothing really helps. The only thing that makes me feel slightly better are benzos that I take sparingly. I have not touched any further drugs, stimulants ever since, with exception of the occasional alcoholic drink and cigarette.

I would much, much appreciate your opinions on what the answers to my question could be.

Gracias!

Franco

 

[herbavore]

- It's all in my head, results from worry, and leads to 'pseudo-neurological', cognitive symptoms that lead to more worry?

I doubt that it is all in your head but certainly its common to have a hyper-awareness when worrying that you have permanently affected/damaged your brain. Practicing ways to calm your thoughts should probably be really helpful so keep up with the meditation and look into both CBT and Mindfulness.

As far as the existential worry--what if you could take the fear out of it and simply observe it as one more facet of being human. We are ultimately alone and sometimes we come face to face with that in a way that creates uncertainty and discomfort but it is possible to simply accept it and carry on with all the wonderful connections there are to be made. Right now you have a wonderful new guru for that in your life: your child! IME no one pulls you into love like a baby does. No one can teach you how to be in the moment like a baby can.

I think if you keep doing all the great things that you are already doing for your physical health, and focus on diffusing the fearful thoughts, you may end up in a better place than ever. I think you learn a lot by having drug experiences like this. If nothing else you learn your limits!8)

I'm sorry that I don't really have an answer as to what may have happened but it seems that may not be as important as how you frame your thinking around what you are experiencing now.

 

[Moreaux]

When was the last time you saw a doctor? Have you had a stress test done? Though uncommon, young people with heart issues may have a reaction to some of the substances that you referenced on that night. Some of the symptoms you describe (numbness, insomnia, anhedonia, brain fog, head pressure, and anxiety) often appear after a cardiovascular event, I'm not saying this to try to scare you, but if you previously didn't suffer these symptoms until after a night of stimulants it is possible you had a cadivascular event, possibly expaspersting a previous condition you were unaware of. I think you need to see a doctor, and be honest about the night and how you have been feeling since. You have a child now and it's very important that you are aware of any major health conditions, particularly if it could possibly be passed along to your child.

I have had several friends that had minor conditions that were undiagnosed and not problematic until they used stimulants. Also, the feelings that you described are similar to feelings my Dad had after his heart attack, and my Mom had similar symptoms after a minor stroke. She had her stroke later in life, and had actually had a life long heart condition that was not diagnosed until she was in her sixties. The symptoms went away in time, though for my Dad it required treatment with blood thinners and stents. My Mom had those symptoms for two years.

Herbavore gave sound advice so I'm not going to reiterate what she said, but I also think you need to get a good physical and talk to your doctor as well. Good luck and congrats on the birth of your kid!

 

[Franco87]

Thank you both so much for responding. Themere knowledge that someone´s listening and responding is so supportive.

Herbavore,I will continue to work towards an emotionally balanced state; One of thethings I´ll start with shortly is, in addition to mindfulness, the practice oftranscendental meditation which seems to have brought many stress-plaguedpeople to relief. The thing is that the main symptoms I have do not feel´emotional´ / ´stress-related´ at all! They rather feel truly neurological,cognitive in a very physical, ´brainy´ way! Which in turn is so scary.

Whichleads me to Moreaux´s points: I have been to 5 different doctors and have beentruthful to all (GP; neurologist; endocrinologist; psychiatrist); but havenever thought, nor have I been told by any of them, that these brain problems could somehow be linked to the heart and cardio-vascularsystem.

So whileI have done tons of blood-work, as well as an MRI of my brain and neck (withall results being normal, which, I assume, rules out the possibility ofstroke), I have not to date done a cardio-related stress test.

[FONT=Verdana, sans-serif]I do,however, go for some more-or-less sportive swimming (1 km) and jogging (5-10 kms) twice per week, and I have in recent months not noticed anything out of the ordinary. It is true though that for years I have had a tendency to develop debilitating headaches after physical exercise.[/FONT]

[FONT=Verdana, sans-serif]Also, during weeks and months after the incidence I did also notice a lot morefatigue while working out which I ascribed to my deplorable cognitive state aswell as the sleeplessness of young fatherhood.[/FONT]

So, couldthese symptoms really be cardio-related? If yes, would I not be dealing withother, more ´leading´, symptoms such as increased breathlessness and chest pains?

Thanksagain so much.

Franco

 

[Moreaux]

What really concerns me is the sudden onset of fatigue, mental fog, numbness/tingling in your left hand and foot, headaches, and the anhedonia. I'm also worried about the headache you get after intense excersize - that's a red flag to me that something seems to be off with your circulation. While these symptoms can present with a number of different conditions, they also present with certain cardiovascular conditions as well and if it were me, I would try to get a stress test and possibly and imaging with radioactive dye if my doctor would go along with it. It's possible to live with an undiagnosed cardiovascular issue for years that can go undetected because your heart sounds normal and you don't have any symptoms. Over time the condition may worsen and symptoms will present. The fact that this happened after a night of Coke is concerning. You've seen several specialists and haven't really gotten any answers, I think it would be worth exploring as you don't want any abrupt surprises in the future.

Of course, I am not a medical professional so take it for what it's worth. I know when I would have Coke nights I wouldn't feel great the next day, but it was never terrible and it didn't persist. You didn't do a lot of Coke that night, which also worries me as it shouldn't have had such a lasting impact. I had a friend while at university who would have particularly bad come downs/hangovers from Coke and he eventually had a heart attack at the age of 22.