seratonin syndrome + ssris + xtc question

[flashdance9]

Hey all,

I'm on 200mg Topamax, 20mg Prozac. I've been on this medication for a few months now (note: the topamax i'm on taking for seizures) 2 nights ago I drank a bunch of alcohol and drunkly decided to take 3 xtc pills with my boyfriend. It was a horrible mistake. A great night rolling, but the comedown felt like seratonin syndrome. I felt like I was going to lose my breathe, confusion, paranoia, trembling, sweats, headache, nausea, diarrhea, suicidal thoughts, EXTREME dehydration..I felt like I was going to die. Luckily I made it through the night. It's now been 3 days later and I still feel a bit off, anxious, emotionless, sad, very fatigued, tingly..I feel like if I don't stay present in the moment and let my mind go then i can slip and go insane or just get mentally retarded at any second. It's very frightening and it seems like a serious matter that I need to be doing something about. But I don't know what.

For any users who have had seratonin syndrome before from taking xtc.. please tell me, what is going on? I know that this happend because of the topamax, prozac, xtc combo. If I just did xtc alone this never would've happend I'm sure. I'm really frightened that I'm screwed for life. I almost died that day.

Has anyone else ever taken xtc while on ssris and experienced this? Will I be okay? Should i stop the ssris immediately? I'm scared to get seratonin syndrome again.

 

[Folley]

If you're not dead yet, you're probably going to be OK.. but do have someone around that can help you if things get bad, if you're not seizing up though, it probably isn't TOO serious.

All you need is time and a positive outlook, this will get better eventually, but you need the time to recover to do so.


Abruptly going off of your SSRIs is going to cause a shock to your system that probably will not help. But I would recommend trying to taper (slowly) off of them. Unless you REALLY need them, SSRIs are most likely going to cause you a lot of problems later in life....

They're over prescribed and have caused a lot of people a lot of pain.




The most important thing right now is just to take it easy. Don't drink, don't smoke, just rest. Wait at least a month before taking any hard drugs again, weed is generally seen as OK, but will still slow your recuperation.

 

[flashdance9]

Thanks for your response. I am certainly not planning to do hard drugs for a REALLY long time if ever again. I am abruptly stopping topamax because i fear continuing taking it along with prozac feeling this *weird* way will really trigger something unpleasant. I don't have any smaller dosages other than 200mg. I don't need it that desperately. As for prozac, I'm unsure if I should continue it..will it do me any good to help with seratonin syndrome or will it do more harm then good? I also don't mind stopping that abruptly. Maybe I should just stop topamax first for a while and then prozac later.

I am still feeling very spacey. Should I take 5htp? I'm really scared for my brain.

Thanks once again for your response.

 

[Folley]

5-HTP is actually toxic, get L-Tryptophan, its the same thing, but MUCH better. That's not what you need right now though...



DO NOT STOP your medication though... that anti-seizure medication may have saved you from some nasty seizures that SS can bring. After taking a drug for a long period of time your brain gets used to it, and will function abnormally without it.

This is why I cannot stress enough not to go off your meds abruptly, to do so will throw your brain even more out of balance than it already is. Also, if you have a history of seizures, this is going to be a very high risk time for having one, so again I do not recommend going off the topamax.


You need to stop worrying, I'm sure you'll be fine, but right now you really need to play things safe. Stopping your meds won't help anything, the damage is already done. The best thing you can do right now is start decreasing your dosage slowly, you don't have to take a whole pill/capsule, you can still control your dose.



Just chill out... relax. That's the BEST thing you can do right now, maybe try and secure some benzos (xanax/vallium/etc) to prevent any further complications. Don't be taking any "supplements"... and if you feel like the medication is going to really make things worse consider going to the doctor, they will only want to help.


You're going to feel "weird", that's probably pretty normal after a neurological poisoning...

 

[Deathduet]

I would ssuggest you wait it out normally (youre gonna hate me for this next bit) but sunlight and routine exersise over the next few days/weeks are your friends! Dont quit SSRI's instant or you'll mess your head something rotten, especially when you're still hazy from the md for the next few days, nothing'll make sense lol... And relax! Like Folley said, you're still alive and sound of mind! Just sounds like you had a lot to drink and a bit too much md .. alco & md are a crappy combo, psych~md effects with physical~alco effects.. not nice.

http://en.wikipedia.org/wiki/Topiramate#Overdose
Topiramate should not be suddenly discontinued, as this may cause increased seizure activity.
^^^ Take note.
Take care and rest up!

 

[gooballs]

Have you already stopped your antidepressants? If so and you aren't experiencing any withdrawal symptoms I would continue to not take them, that is if you are sure you had serotonin syndrome. The problem is SSRI discontinuation syndrome can mock the after-effects of SS, so it would be hard for you to tell after the fact. Either way though DON"T stop the anti-convulsant, not only can you take those right now, but you should be.

If you've been taking your SSRIs ever since this happened and haven't had further complications you should probably be okay going forward. If the symptoms get any worse I would look into a safe way for you to ween off your SSRIs. Despite what others may say about what normally happens when stopping SSRI, this of course would not be a normal situation. Your SERT system is likely already damaged and your serotonin axons need to regrow. Temporary or permanent discontinuation of the offending agent is the first step you should after SS, allowing your brain to re-wire without any complications. It is possible for the syndrome to manifest and for there to be a second episode otherwise. As I've said before, the effects of SSRI discontinuation syndrome are far less serious and cause much less neurological damage than SS. Regardless, now's the time for you to begin into tapering yourself off the prozac in a responsible way.

Usually when SS occurs due to prescribed pharmaceuticals only the case only last a couple days and the person can continue with their medication. No prescription drugs affect serotonin levels anywhere close to how much MDMA does. That's why the process may take a little longer and and should be approached cautiously.

I experienced SS too but it was not due to SSRIs and molly, it was 5-htp and molly (the mechanisms are similar but not exactly the same). Personally, I can't do any drugs that even slightly effect my serotonin levels for a very long time or I'll experience extremely adverse and horrifying effects. I don't mean to scare you at all, your case may be different, your brain has most likely reached a point where it relies on Prozac for efficient use of serotonin, but increasing the time serotonin stays in the synapse is not what you need right now anyway. What I do know is that your brain needs time to recover if you experienced SS and an antidepressant such as prozac with strong serotonergic properties and a high correlation to SS is not going to help this process go faster. Do not take 5-htp or any of those supplements, they can cause a major setback.

Right now there is no drug you can take that will fix this problem, and I know how desperately you want to fix it. Do what the someone else said, exercise and eat healthy. Those are really the best things you can do you will feel major relief in a couple days I assure you.... What I think the real problem is here though is that it is not quite definite that you experienced SS, and its hard to tell based on the brief description. There are other possibilities. I know it sucks to relive something like this but if you can go into a little more detail about what happened maybe I can be of more help. Here's something you may find useful in the meantime http://www.antidepressantsfacts.com/reaction.htm
Oh and you're going to be okay now, don't worry. The worst of it is over, that much is definite.

 

[First Bad Comedown]

Yes you should stop taking Prozac.
Especially if you are continuing to feel agitated, anxious, or shaky.
The FIRST medical step with serotonin syndrome is to IMMEDIATELY stop ALL serotonergic medications and drugs.

That means no prozac and NO 5-HTP.
Or tryptophan.

For God's sake, listen to a person that experienced a near-death SS a year and a half ago!
Stop taking ALL serotonin agents now.

Yes, Prozac withdrawal can and will occur.
And abrupt discontinuation is only called for if you are experiencing significant agitation, known as 'akithesia'.
If not, a slow and steady tapering process should begin, today.

Cut your pills into small pieces if you have to.
And tell your doctor what happened and that you are withdrawing yourself from Prozac.
If they try to stop you, find another doctor.

Normally an SSRI will not react with MDMA to cause SS - in fact they will BLOCK the euphoric effects of the drug.
But it can and does happen.
And a STUPID high dose of MDMA like three pills is just the risk factor required to push you over that edge.

Fever is considered a reliable gauge of SS severity, with 101.4 being considered a VERY serious SS reaction.
Even a mild fever of 99.5 is a confirmation that it happened.
Mine never got above that, but my other symptoms were so severe I am shocked that I didn't die that night.
In a way, I did.

18 months later I am still recovering, and the first six were VERY VERY difficult.
Those words don't really describe the process - no language can adequately communicate the amount of suffering that a human mind is capable of.
Good news - it stops.

No matter how bad it is, the suffering will actually start to get better and one day fade away.
But it takes a VERY long time for some people.

In my experience there are three groups.
The lucky ones will return to 'normal' within 4-12 weeks.
The next group will take 1-2 years to stabilize and will continue to exhibit symptoms and cognitive changes for many years.
The last group is a very small minority and may continue to suffer for 2-4 years.

The timeline of 1-2 years is pretty damned solid - spanning many different areas of research.
From SERT binding, to rCBV, to self-reported depression.
12 months is the real goal for many people to reach, with the first six being impossibly hard to endure.
I hope it doesn't turn out to be this way for you.

The strange thing is that for much of the 'hardest' time I actually felt NORMAL cognitively.
There were many days that my symptoms receded and i truly believed it was almost over.
How wrong I was.

More good news - EXERCISE MAKES A BIG DIFFERENCE.
It releases a serotonin nerve growth factor called BDNF into the brain.
It also grows new brain cells and sprouts new blood vessels.
Exercise was SO hard for me in the beginning, but after thirty days of feeling DEAD I decided I couldn't sit around and starve to death.

So I worked out five minutes.
Then ten.
And just a modest effort like this made the greatest difference in my symptoms.
It did not HEAL me by any means, but it controlled and influenced the horrific process that I was destined to endure.
No greater method of control exists for you.

So start tearing muscle fibers and breaking a sweat.
Today.

And repeat it tomorrow.
The benefits grow more with each day of repetition.

Stop taking the prozac slowly.
Start exercising slowly.
Eat as healthy as you can and brush your teeth four times a day.
That last part will reduce inflammation in the brain.

Piracetam is a miracle - and it works upon the same structure that both SSRIs and MDMA depend on (and damage) - the hypothalamus.
Only it wont down regulate serotonin receptors in the higher brain like the other two.
I warn you - it is NOT a cure.

But it is a glorious pause button.
It will make you FEEL normal, after a period of agitation.
I took it for much of the first year, but everytime i stopped the suffering and rewiring was waiting on me.
Every time.

I don't think it hurt my recovery, but it certainly delayed it.
And by 'recovery' I mean the degeneration of higher brain functions and emotional identity.
The odd thing is that for every bit lost, there is a gain in calm and stability.
Make any sense?

I don't want my post to scare you, because I know how intense the suffering and worry can be.
It is so bad that people telling you to stay calm are a JOKE.
Right?

If you are hurting that much that you just can't sleep....you can't sit still....you can't stop feeling FUCKED in the head 24/7 - buy the piracetam.
Its cheap and legal without prescription.
And I swear to God it saved me from the depths of hell that few can imagine.
For now it may be your only hope.

Do NOT take tryptophan or 5-HTP.
You are not just 'low' serotonin right now - you have lost some of the storage capacity for it.
And taking serotonin boosting drugs might make you feel a LOT WORSE.
Not to mention the ongoing and REAL risk of serotonin syndrome because of the prozac!!!

Exercise, exercise, exercise.
Hear me?

You have no choice.
If you want more answers you can browse my old posts.
They are quite full of obsessive details.
The amount of research and writing I did was incredible, so use it if you must.
Trust me, there are very few on BL or anywhere on the internet with answers for you.
Even doctors often know SHIT about the serotonin, the brain's most dense neurotransmitter system.

It is the circuitry that connects your intestines to your brain.
It controls blood supply in the brain, dopamine transmission, and has a profound effect upon the pituitary and adrenal systems!
There is much to learn, but little to do.

Piracetam.
And EXERCISE.
And time.

Let me know if you have ANY questions.
FBC

 

[gooballs]

I was waiting for you to come round to this one.... Listen to first bad comedown his advice has helped me so much more than any other possible resource ever since I got ss. And trust me I've tried find a lot, with very little success. It's a long road to recovery and you need to make the right steps. You will start to feel better.