Possible Seratonin Syndrome (tramadol), looking for input.

[Jar Of Flies]

A little background. I am an on-and-off opiate user- mostly hydrocodone and tramadol. I kinda, sorta go in “binges”- I will take for one or two months, then take a break, then go on again…sometimes I will completely stop, sometimes I will keep it to once or twice a week, been in that mode for several years now (I know, I need to quit, though that is a topic for another day).

Anyway, I had a VERY scary experience the other night.

I have had access to tramadol (legitimate actually) for the past two months.

My current usage has been 8-10 a day for the past month.

I have used these amounts (on and off) many, many times with no issue.

I took my first four at around 6pm. I felt the light buzz come on. I added two about an hour later, another two about 2 hours after that, and the final two around midnight for a total of 10 (like I said, par for the course for me).

I started to feel nauseous after the last two, which is weird because I have taken far more before and have never got that feeling on trams.

About 30 min later, I started to feel violently ill. I start sweating so much that my shirt was soaked. My heart started racing super, super fast to the point of scaring me. For the first time in my life, I thought I was going to have to call an ambulance (scary for a veteran like me). I wasn’t delirious or anything but just more scared than anything…my legs felt like jelly and that if I stood up I would collapse.

I rode it out for about 20 minutes, and all of the sudden it just went away- like a switch had been turned off.

I thought maybe I ate something bad, whatever- I enjoyed the remainder of the high either way.

I took four more the following evening just to sort of get a handle on how I was feeling-I felt strangely nauseous again (though nothing like the night before) and slightly panicky and that “scared to think” feeling you get when your anxious.

When I woke up the next morning, it hit me on the way to work that maybe I had something that I had heard about before (but never delved into much)- Serotonin Syndrome.

Opinions? Was it really Serotonin Syndrome? Could it happen after taking it so long just on a whim like that?

Like I said, that dose and timeframe was nothing new to me. I am hesitant to take anymore because I don’t know if my brain needs to heal, or what.

All input appreciated.

 

[DoctorJC]

There is a possibility that you may have given yourself seratonin syndrome. I've had a buddy double his dose of Zoloft once on accident because he forgot to take it and it happened to him, the thing is he still ended up taking only half of what I used to take normally. 100mg vs. 200mg. I mean there's a couple of things to consider. Did you eat any sort of citric type food, especially grapefruits within the same timespan. Do you take any sort of anti-depressant, even MAOIs or TCAs. From everything I've learned about Seratonin syndrome it's sounds like the symptoms were there but I'm no doctor so I'm not going to say for certain. Do be careful with Tramadol though, you didn't mention what mg you were taking, you said popping a few pills of it is nothing new to you but the balance of your neurotransmitters is a delicate chemistry and even taking your normal dose of something that raises seratonin levels can upset the balance.

 

[Cloroxtastebad]

I got serotonin syndrome last month after being moved from 20 to 40mg of prozac and adding doxepin 50mg for sleep.

My experience was very similar to yours. I was fine then all of a sudde my heart rate shot up, I got sweaty as could be and shakey. My pupils became very dialated and I got sick to my stomach. I ended up going to the hospital because after 3 hours my symptoms had not improved. Even after 3mg of Xanax and. 3 Mg of clonidine.

At the hospital my BP was 188/110 and hr was 125ish. This is very high for me. They kept me 2 days and sent me home. I had to stop doxepin and lower prozac.

Serotonin syndrome can come out of nowhere like it did for you. Usually its tipped off by the addition of a substance. Its like you have been close the the threshold but not there yet, once u go over u experience serotonin syndrome until a good deal of the drug has been excreited.

I would be carefully about how you go about using again. I would suggest moderation and see how it goes.

 

[Jar Of Flies]

Yeah, in my case though I did not add anything, and the dose I took was nothing out of the ordinary for me. But Clorox, your theory about the threshold makes sense too.

 

[TJ5]

Like Doc JC wrote, grapefruit juice and/or other MAIOs/antidepressants would definitely be a big red flag. Also, certain foods even, sorry can't think of the names of all, but MSG comes to mind. I know many foods are off limits to certain antidepressants, and since Tramadol is one, you have to be VERY careful what you take with it. There was a time when I had Trams on hand for an emergency only, meaning when I had none of my Rx painkiller and had been needing to take the edge off of not having any opiates--often times cold turkey when my Rx ran out. This was back in 2004 or so, and before the days I had any idea that Tram was in fact more than just an opiate agonist--a mild ACTING opiate without actually being an opiate--hence the reason I had used it on maybe up to 10 occasions to help come down off my REAL Rx dope, which equalled approximately 10mg-15mg methadone ok. What I did NOT know however, was that taking Tram after my drug of choice, IV meth, could of potentially resulted in heart arrhythmias, as speed and antidepressants don't mix. You made no mention of using MDMA, coke, or speed, but I thought I'd throw that out there. I'm not even sure about caffiene being safe to mix with Tram. That said, check out lables on foods bought at store. Most have some kind of long names of preservatives whose names I can't even pronounce. One began with the letter T. It's in pizza sauce, & a boat load of other foods to prolong shelf life. That said, I would defo refrain from using Trams if I had eaten any foods with these preservatives as stated above. In fact, because speed is an issue with me, I have avoided Trams altogether since 2009. I don't know a whole lot about this seratonine syndrome, in fact it's the first time I've heard about this particular "syndrome" by name. This is what I DO know: I had been clean and sober off ALL fun drugs/alcohol some 18 months. I made the HUGE mistake of taking Trams, not to get high, but to take for pain instead of the Vics ES offered from a shitload of dental surgery. I thought it would be the "smart" thing to do, as that way I'd not be taking any actual "dope," yet have something stronger than motrin for the pain. I can only tell you that for me, that had been the dumbest, though unitentional mistake I had made--& ultimately as they said in NA, what "took me out." I figured it wouldn't hurt me since IV meth had been my DOC, opiates my 2nd. I knew without question taking amph or methamp dope would do me in. Trams did in fact wake up the dormant opiate beast in me first off. And, although I DID try tapering off the Trams with a healthcare professional, had gone to MD and had over $600 worth of tests to determine the cause of why, no matter how much, or how little sleep I had each night, ate right, went to gym 3x week, even lost over 50 lbs, & while I regained my physical mobility and managed to ditch this pre diabetic condition--hundreds of $$ of tests later there was STILL no answer as to why the persistent, chronic fatigue after 9 months of following the MDs advice. Also too, just as horrific the anhedonia from hell that just would NOT leave me the fuck alone, would NOT go away, ultimately making it physically impossible for me to work 6 nights a week. I managed to work and maintain a 4-5 night work week for 3 more years, but it took every ounce of energy I had just to get up and go to work each night. I had been a verteran drug addict some 25 years before being clean 27 months. During the last 9 months of being clean off all but Trams, the pharm and the doc thought the symptoms of stopping or even not stopping Trams were all my imagination. I wondered if I was crazy imagining this myself until I had gone back to my old hood and asked some still hard core users about this Tramadol, plus researching here on BL. I learned that even taking as little as 2 Trams a day for more than a week had caused w/ds in other fiends. There have been infrequent, irregular intervals of these heart palpatations I've noticed intermittently, several times after taking Trams. Still, the anhedonia and the chronic fatigue---that had started during an extended period of being drug free---27 months total---the last 9 months of them being the onset of the chronic fatigue/anhedonia-all when tappering from Trams, or attempts to do so. Numerous failed attempts at kicking Trams left me feeling WAY worse than all the times I'd ever kicked my regular Rx dope. I had officially kissed my sobriety goodbye during my last attempt at tappering Trams. I finally tossed the Trams, suffered no more w/ds of persistent anhedonia and chronic fatigue, but only after a maintainence dose of my "real" Rx dope & only given a 24 hr reprieve from chronic fatigue/anhedonia. Almost 4 years have past since this whole Tram chapter in my life. Like you, my former Tram use had been anywhere from 1/2 pill day on up to as many as 10 pills/day-which went on for about 6 months--when I knew I had to stop. I did notice, however, I defo started to feel "funny" as in not quite right. My symptoms weren't as dramatic as yours, but first thing to go was the pleasant buzz upon taking more than 6 pills/day. At 8-10 pills I noticed mild, intermittent heart flutters on several occasions. I cut back to 6/day max after that, but whether I took the Trams or not at regular dose, although I can't quite explain what exactly was different or lacking, aside from the fatigue/anhedonia. Since my Tram days, even after almost 4 years of not taking them, I've never felt "normal" since. My brain chemistry has been altered and hasn't been the same since. The worst symptoms even 4 yrs after stopping Trams are chronic fatigue and anhedonia. When kicking Rx barbs/opiates cold turkey or hell even speed for that matter, while we're talking serious ass suckage here, I NEVER felt as horrible as I did kicking Trams, nor have I had to suffer the still lingering effects of anhedonia and chronic fatigue. Please be warned. Best of luck.

 

[Jar Of Flies]

Thanks for the input TJ5! Do whatever it takes to stay clean man. I am starting to think that event I experienced is the universe telling me to quit being an idiot and confront some people/problems I have been brushing away.

 

[Tony7777]

Serotonin Syndrome?

I believe I got Seratonin Syndrome from a supposedly natural supplement, which turned out to contain Sibrutramine, a seratonin enhancer. 15 days ago I stopped usage of the supplement after almost fainting. Since then my head feels lite like jet lag, sensitive to light, pupils occasionally dilated, increased pulse. In fact 9 days after stopping was in hospital with fast heart 135 bps. At this point my heart seems to have stabilized back to a normal rhythm. .pulse at rest 62 to 80..versus 90 to 100. However I keep getting new symptoms like left hand jittery, exaggerated reflexes, dilated pupils. How long will this keep up