Stimulants Differentiating between stimulant induced panic attack and serotonin syndrome?

[fbuld]

Hi, I was wondering if anyone could chime in on this subject, regarding differences in symptoms and aftereffects based on your own knowledge or past experiences?

This is also personally relevant to someone I know as well, because he experienced tachycardia (around 150 bpm), painful headache that felt like it was shifting sides, neck muscles contracting, agitation, electrical sensations, and cold/hot flashes that persisted for a couple of hours.

This condition was supposedly brought on by a combination of 80 mg of adderall xr (prescribed 40 mg, took the 70 mg 6.5 hours before symptoms arose), 3 grams of phenibut (3 hours before onset of symptoms. he has a very high tolerance for information purposes), 30 mg of dxm (3 hours before onset of symptoms), 200 mg of 5 htp (had been taking that much daily for 2 weeks prior), and a few hits of weed (10 minutes before onset of symptoms).

This all happened 3 months ago and he still experiences bad shifting headaches daily, nervous eye brow tics, decreased mental/physical tolerance to stimulants, increased daily anxiety, and even panic attacks once a while.

ECG and blood tests came out fine. Main thing that bothers him though is the persisting headaches that he'd like insight on.

 

[Stotched]

Serotonin syndrome is actually a very rare condition unlike what people would have you believe. The reason it's taken so seriously is that it can permanently mess you up. I remember seeing a megathread on DF a while back where a few people who legitimately had SS and they had lingering symptoms for months afterwards. I'd say he should mention to the doctor that he used a combintation of drugs that can cause it, and see what the doctor says. A doctor is not a cop, he's not going to snitch on you, and has to keep your info confidential. If you didn't tell him you were using illicit drugs, especially ones that can cause SS, how would he know what to look for?

First of all, Adderall and DXM alone can cause serotonin syndrome, not to mention the 5-HTP. You should never take more than one drug at a time that affects serotonin. Also, people on this board will defend weed, but a while ago I took a large dose of kratom, 30mg vyvanse, 30 mg dxm. I was fine all day with this, and on the comedown I smoked a snap of about .6 of medicinal weed. I instantly got the shakes, started blacking in and out, and getting hold cold flashes. I also had headaches for about 3 weeks after. This leads me to believe that weed modulates serotonin in some odd way. It may not release it, but maybe it modulates it in the same way acid and shrooms do.

The fact that you have headaches 3 months after says you may have had serotonin syndrome. Like I said, go to your doctor, and tell him the cocktail of drugs you were on. When it comes to drug use, you need to be straight up with your doc, or he won't know what to do.

 

[TheLostBoys]

That's entirely too many drugs to be ingesting at once.......DXM + Adderall is a bad combo.

I stay far away from stims because the smallest mistake & you can screw up.

IMO, I may have has SS back in 1999 from MDMA, using it 3 straight days with friends & partying with not much sleep. Then smoking weed which the symptoms started & I did the EKG & other tests & I was fine but the dizziness, heart beating fast, etc......lasted for about 2 months, it sucked big time!

 

[Stotched]

That's entirely too many drugs to be ingesting at once.......DXM + Adderall is a bad combo.

I stay far away from stims because the smallest mistake & you can screw up.

IMO, I may have has SS back in 1999 from MDMA, using it 3 straight days with friends & partying with not much sleep. Then smoking weed which the symptoms started & I did the EKG & other tests & I was fine but the dizziness, heart beating fast, etc......lasted for about 2 months, it sucked big time!

Like I said above, I do believe weed affects serotonin. I had what I believe to be SS as well, but I was fine all day until I smoked a bong. That's 3/3 people in this thread who had their symptoms start after smoking. I guess when weed gets dropped to schedule 3, or legalized completely we will find out almost right away how weed affects serotonin.

 

[TheLostBoys]

Will be very interesting to see if people start to flip out thinking they have SS........I wonder if there are many people feeling any symptoms in Colorado?

 

[fbuld]

Is there any blood tests he can ask his doctor for in hopes of achieving a more objective diagnosis? His doctors says stress and anxiety can trigger the headaches, but I don't know. He needs to use his adderall for schooling, so hopes he won't have to give it up entirely.

He's been also been meditating for 40+ minutes a day the past week so, if these symptoms are from stress/anxiety, maybe he shall be enjoying some improvements eventually.

edit: if it makes a difference, the headaches get worse when anxious or exercising.

 

[TheLostBoys]

Does adderall make you anxious?

I know after my 2 month episode, last thing I wanted to ingest were stimulants.......

 

[fbuld]

Yes, defiantly more then before (particularly at the beginning of the dose and comedown), but idk if its all psychogenic or actual nervous system instability. I'm currently taking a summer class with the final exam next week, so thats why i've been taking it recently. Play on taking a decent break when its over with though.

edit: This original episode occurred on a thursday and the prior saturday I consumed 200 mg of really good MDMA if it makes a difference in setting myself up for SS

 

[TheLostBoys]

^^^^^^


Yes, the 200mgs of MDMA makes the difference.......

I had some really good X back in 1999 & people were loving this stuff......I ended up doing it 3 straight day & not much sleep, it really was a mess on the 3rd day & needing sleep.......the lengths we will go to have fun & feel.that euphoria.

Back then, there weren't forums like this where I could go to get info & didn't know jack about serentonin syndrome.

Even if this site was around which it may have been, not many knew about it.

Sites like this one has helped & saved many lives & continues to help many many people every day........

 

[sekio]

What you describe is a hypertensive crisis event, not serotonin syndrome. Serotonin syndrome is kind of different than a hypertensive crisis, which is what most people experience when combining amphetamine + other drugs that effect epinephrine (DXM being one of them). Plain old amphetamine just isn't a very good serotonin releaser, and people these days have a tendency to ascribe any and all bad drug effects to "serotonin syndrome" because that's the name they know about.

So to summarize: it's the norepinephrine that gets you, not the serotonin. MDMA and DXM is serotonin syndrome country, not plain amphetamine and DXM. The effects are still nasty - high blood pressure, anxiety, agitation, etc. but it's more congruent with the drugs you actually take.