TDS Low Serotonin + Immediate Serotonin Syndrome

[foxyproxy]

Whats up guys, long time reader (lurker, if you will), but this morning I woke up with a sudden moment of clarity after an exhausting 2 days of food poisoning. I have a friend of mine who is a little shy to post on a public space, she has a pretty long history of having low serotonin. Largely characterized by repetitive suicidal behaviours, anxiety disorder, insomnia, depression. All very chronic and pretty debilitating.

But see, there's another side to this. She's no stranger to club drugs and may have over-done it one or two dozen times. She remembers the incident that triggered one of the hardest things she's had to deal with, perpetual serotonin intolerance. She was struggling to sleep one night, as she often did, and she took another melotonin to help her sleep. Unlike the last few times where it helped her sleep with no side effects, this time it seemed to have the opposite effect. Within an hour she was pouring sweat from head to toe, the room was spinning, she felt the same way she would feel in the past if she took way too much ecstacy. Not good. This could have been the "last straw" for her brain, maybe, even though that's been very depressing and hard for her to come to terms with. Ever since then (4 years later), she has the same problem if she takes anything affecting serotonin. Any kind of drugs, especially SSRI's or similar, st johns wort, 5htp, even the smallest doses of them, or any drug or foods that effect serotonin will immediately set of a cascade of serotonin syndrome symptoms. Pouring sweat and high body temperature, irritability, derealization, rapid heart rate, confusion, basically the worst parts of the bible.

So for the last 4 years she's had to completely rewire her life to avoid these types of substances, however, her depression, insomnia, and anxiety has only gotten worse and her doctors don't understand how she's intolerant to serotonin. How can she increase serotonin if she is borderline allergic to serotonin enhancing foods or drugs. Does someone out there have any ideas? I don't have a jumping off point that could help get her in the right direction. It would make a big difference, maybe someone here has an idea or has dealt with something similar. I knew someone a long time ago who had a similar problem after taking SSRIs for 20 years and getting off them, but he never found a way to overcome the problem and take serotonin drugs again. What do you guys think?

 

[starting_over]

Somehow I wonder if placebo has anything to do with this...

All these symptoms simply from eating food?

Does sunlight negatively affect your friend?

 

[Moreaux]

I know your friend is seeing a doctor, what kind of doctor? Alternatively, have they spoken to a pharmacist? This is certainly a unique issue, and not one that I have heard of before so I have little insight. Is she taking any recreational drugs or on any medication or supplements?

 

[king kpin]

That is certainly a weird set of symptoms and most doctors would call serotonin intolerance an unheard of phenomena. Could be be caused by purely psychological factors. Thats what I would bet at least.
I would test to see if this is true by seeing if she feels horribly sick like you have outlined above, after mild cardio. Like a hike, or light jog. Exercise would be the best way to help combat all of the above (Anxiety, insomnia, etc), and exercise will definately release serotonin assuming it is moderately difficult. Exercise would be my recommendation. 30 mins of jogging or hiking a day, good for physical health, mental health, and will slowly help her develope a "tolerance" to serotonin if what she is saying is happening.

 

[foxyproxy]

Hey guys. Thanks for the responses. Unfortunately this isn't psychosomatic, although lets just say that she really wishes it was! She does get a fair amount of exercise, at least an hour a day (for the past few years). Not every single thing that could affect serotonin is causing this problem, but most things will. If it's a prescription drug like an SSRI, some anti-psychotics, OTC like h5tp (or st johns wort) and even some spices in food (she has to avoid indian currys). I know how it can seem like its anxiety because it sounds so crazy, but it's true. If you guys have ever done X before, it feels like that, well, not the first time you did X, more like the 150th time you did it. You can go down the list of serotonin syndrome symtpoms and they all intensely manifest. She was on a hospital watch several years ago because a careless doctor had her take half of a low dose celexa, thinking this was all in her head, and within several hours after taking it she was pouring sweat (to the point her face was bright red), body temperature got to 103, and going into convulsions paramedics had to come to her apartment and take her to the hospital. She spent that entire night shivering and hallucinating, seeing things running up an down the walls.

So the question is...I would do pretty much anything to make this stop. Seriously anything. She can deal with a lot of pretty bad health problems she has in her life (that I'm not getting into here), but this one in particular is especially hard for a lot of reasons, namely that she can't take any of the medications that might help the other health problems she has. She thinks that what happened was a combination of a lot of X (and other party drugs) + too much stress for too much time basically broke her brain, and now her brain can't process serotonin drugs any more. That's not to say that she can't release natural serotonin as king kpin says, I think that it's that her brain doesn't have a good way of taking serotonin precursors from an outside source, her brain quickly becomes overwhelmed. She can pinpoint the exact night where she went from being able to handle serotonin drugs to a total intolerance to them (as I specified in my first post). If this is the case, which is what it seems like 5 years later, what kinds of things could I possibly do to try to fix this?

We tried building up a "tolerance", but it doesn't seem like that makes a difference because even when she dipped the tip of her tongue on a small amount of 5htp, she would start getting symptoms (just very mild ones, nothing as serious as an SSRI). We thought about taking serotonin antagonists like Cyproheptadide for a week and then taking a small dose of a serotonin affecting drug but I'm not sure what that would really prove. I really would love for there to be a way to test for the amount of serotonin she has in her system, but such tests seem unlikely to produce anything worthwhile without a biopsy. That's why I'm reaching out to you guys because, unlike the doctors that I know in real life, actually have relevant life experience that they can draw from to help solve such a unique problem. What kinds of tests could I do to narrow down a potential solution? Or does anyone know of a solution outright that we could test? Thanks again!