Mental Health Serotonin Syndrome Recovery

[kr1nge]

On February 7th, 2012, I had serotonin syndrome. It was from a buildup of serotonin from several months of drinking excessively and taking tramadol together. I blacked out before I could call 9-11, and by the time I made it to the hospital my vitals were back to normal so my condition was shrugged off by the ER doctor. I immediately stopped the tramadol, quit drinking, quit smoking, and began the road to recovery...

Shortly after Serotonin Syndrome, I discovered something I'd never seen before: General Anxiety and Panic Disorder. These last 5 months have been a complete nightmarish roller coaster. I can't tell if it's SSRI Discontinuation Syndrome, destroyed serotonin axons from the original Serotonin Syndrome, or a mix of the two. I have the "windows and waves" effect, where I'll have weeks and weeks of miserable pain all throughout my nervous system and migraines that last for weeks, and then I'll get a window; a day where my head is clear, my mind is calm, and I am genuinely happy. If I'm able to get out and run/bike/etc on this window day, I MIGHT earn another window day.

I saw doctor after doctor, and got SSRIs, Triptans, Trazodone, Topomax, and beta blockers thrown at my face left and right... I was too terrified to take any of them. I can't even drink caffeine anymore because of the neurological effect it has on me... how could I possibly take these chemicals? Finally on June 6th, I got a gift from heaven... a prescription for Xanax, which I gladly accepted. 1mg 3x a day and 4 refills. It was a godsend. I broke all pills in half and only took .5 because I still had a terrible fear of being poisoned again, but Xanax relieved all my anxiety and left me only with the migraines, nervous system pain, and DR/DP depression. All those things were much more manageable without anxiety, until recently...

I've been on xanax for less than 2 months, never taking more than 2mg in a day... and now I can't stop taking them, as much as I wish I could. If I go a day without taking at least a .5, I get the same horrible brain zaps that i did when I first started recovering from Serotonin Syndrome.

I'm a depressive, anxious, painful, and weary mess. I'm 25, and I'm convinced that I'm not going to live past 30. I try every day to run and exercise through my migraines and nervous system pain, but I physically can't do it.

Is there anyone out there who has been through this who has advice for me? Should I try the SSRI's or would it only make my condition worse?

I've already had to go to the ER once at 2am and tell them I needed a place to stay to keep from killing myself from the pain, and I'm worried that one day I might not make it to the ER...

 

[jambabomba]

On February 7th, 2012, I had serotonin syndrome. It was from a buildup of serotonin from several months of drinking excessively and taking tramadol together. I blacked out before I could call 9-11, and by the time I made it to the hospital my vitals were back to normal so my condition was shrugged off by the ER doctor. I immediately stopped the tramadol, quit drinking, quit smoking, and began the road to recovery...

Hi,

First I have to ask how can you be sure it was serotonin syndrome? Only tramadol and alcohol? Are you sure it wasn't a seizure from tramadol and not serotonin syndrome? Because what I know about serotonin syndrome usually you will get many other symptoms before you go to coma or collapse. Also I have never heard that tramadol and alcohol could cause serotonin syndrome anykind. I have been also drinking and taking tramadol big doses but no serotonin syndrome or anywhere close to that.

But I think I have some experience with serotonin syndrome (or I suppose so because of the symptoms) when I was using amitriptyline (TCA), tramadol and DXM. I was avare of that serotonin thing but my amitriptyline dose was low, only 20mg at night and I took evening DXM about 300-400mg and had no problems because I didn't use amitriptyline that night of course because I was aware that they might cause problems. Anyway.. that DXM trip was very strong and lasted long because I had drink grapefruit juice wich is my regular drink with food. Next morning when I was going to work DXM was still affecting me some way but I was thinking that there wasn't anymore much SNRI effect of DXM but rather dissociative effects of metabolite DXO wich I thought doesn't act as an SNRI. So I took my regular tramadol dose at that morning of 100mg.

But then about hour later things started to going scary...

At suddenly my heart started to racing wildly and my body temperature started severely raising. In few minutes my t-shirt was completely wet because I was sweating severely. I started having severe headache, nausea, shaking and tremors. I took xanax but it didn't helped much at all so at that moment I was sure it was something else than panic attack (wich I recognice and have been suffering many years) and I could only think it was because of too much serotonin. I think I had some hypertensive crisis at that time because I had also took ephedrine and coffeine but normally with tramadol they don't cause the problems I was having that day. My blood pressure is normally also kind of high but I wouldn't be suprised if it was something like 200/150 because my ear was also popping and really I fealt I'm going to die because I was also mentally little disorientated.

Anyway it started to ease in few hours and then I thought it might be safe to take my protein drink. I was little scared to take it because of high tryptofan content but anyway I took it. Well it was bad idea. I think the tryptofan in that protein shake increased serotonin and my symptomps get a lot worse. My headche came back, I felt dizzy, was panicking, had tremors and was shaking and sweating. Heart started to beating like a crazy again.

It was stupid to take that because my body told me by nausea that I shouldn't eat anything. Well by evening my symptoms started to get better but I still had ex. red skin when I went to sunlight (wich might have been also a stupid idea because sunlight might increase serotonin also) but anyway I decided to take some protein again (I am weightlifter). No bigger problems anymore with that. But then I wen't to my computer and thought to take some fruit juice. I was little hesitating with that because sugar also increases tryptofan content in brain especially when you have ingested protein before. So I was thinking long should I drink sugar containing drink after protein or not.. I decided to drink. And that was BAD idea.

I really felt that serotonin again increased massively because my headaches get a lot worse and my ears started to popping and heart racing and I was sweating like crazy. My vision also get somehow blurred and I got chest pains and nose bleeds. I really felt I had hypertensive crisis again and was scared and thinking to go ER.
Anyway it got better after an hour or two and by the evening I took clonidine and felt how my blood pressure went down and I got a little better.

After I had survived that I had same symptomps as you had: My mood was very low, I had panics, depression, lack of motivation, very bad fatigue, withdrawing from social situations etc. But after about two weeks I started to feeling about normal again.

I think you haven't permanently damaged anything. That was what I was also thinking but brains are very adaptive. I think it is the psychological thing wich makes a biggest problems - at least in my case.

Best luck to you anyway, try to stay optimistic. Your body and mind needs time to heal.

Edit: Oh, I forgot that drinking. It is what causes general anxiety disorder, panic attacks, deprsession etc. If you had been drinking excessively I would bet that there is the root of your anxiety problems and not the possibly serotonin syndrome. If you could tell me how are you sure you had serotonin syndrome? Did you have same kind of symptoms like I had before you passed out? Or how are you sure it was serotonin syndrome? Sorry I'm skeptical I don't mean to be rude but it just sounds very unlikely to me that only tramadol and alcohol would cause severe serotonin syndrome. But I could be wrong also.

 

[kr1nge]

Thanks for the reply! Yeah, I had all the classic symptoms. Hypertension, tremors, hallucinations, fever, muscle fatigue, vomiting, diarrhea, delirium, and of course that feeling of impending death. You know how there's 2 kinds of people, the "I think I may have had serotonin syndrome" people and the "HOLY FUCKING SHIT I HAD SEROTONIN SYDROME OMFG WTF I ALMOST DIED HOLY SHIT" people? I am of the latter. I was so delirious that I couldn't figure out how to use my phone to dial 911 before I slipped into unconsciousness. Believe me, that was legit.

I'm sorry that you experienced it as well. The experience is something I wouldn't wish upon my worst enemy. I'm glad you recovered within 2 weeks. That's about the time the brain zaps went away for me, but the anxiety and depression remained and still haunt me to this day

 

[bpayne]

how would alcohol contribute to serotonin syndrome with Tramadol? It was possibly just too much tramadol.. I have never read of alcohol contributing to a serotenergic episode

 

[jihwaan]

As I posted in another thread but to ensure this info is viewed by as many as possible I will spam this thread sorry guys:
I hope this helps someone.
"For moderate or severe cases of serotonin syndrome, patients should be hospitalized, and neuromuscular paralysis, sedation, and intubation may be indicated for critically ill patients."

I should in fact be dead a couple of times over according to a few of the doctors who attended me throughout my little adventure- (yes I am a little twisted and it was a hell of a ride but never again).
So I have just came out of hospital after 5 days then another 7 days in an induced coma (well one 5 day coma, pulled out, still incoherent and feverish, cramping blah blah, put back into induced coma for another 7 days, kept in ICU for another week on 4 hourly OBS and 8 hourly bloods).
My point- you don't want to f*ck with this one kids - I am a hard arse with an unusually high tolerance for anything- medications I had been on for at least a 4-5 month period leading up to this adventure:
Wellbutrin XL 300mg
Wellbutrin SR 150mg
Seroquel 150-200mg of an evening to help with sleep
400mg (2x 200mg per day) tramadol
some fine synthetic cannabinoid substance I am not going to disclose
1 GRAM PER DAY cocaine substitute I am unaware of the make up of
two 'herbal XTC' pills
half a litre of good 80 proof Russian vodka each evening.
Prescribed something called 'epilem' but neevr filled the script.

Now keep in mind I did spend 4 days at home walking in circles, falling over myself refusing to go to hospital in insane agony, obvious massive discomfort and delusional bouts of imagination of the most insane realities where enacting themselves believe me it was real to me. After 4 days of watching me not eat and degrade further (I would have still been taking my meds so increasing the problem exponentially) after 4 days of watching me walk in circles my fiancée of 8 years had me collected by ambulance, where upon doctors diagnosed a drug overdose- interjection..... I would rant here and ask what illegal drug does this shit right- ANY WAYS BACK ON TRACK after hours of arguing my fiancée finally convinced them ALL the myriad of symptoms - it was prescribed medications in prescribed doses and highly likely the dreaded 'seretonyn syndrome' (She is adamant this is the third time I have had SS, this being the worst by far- I have no recollection of the few days surrounding each of the previous two incidents she refers to).
So all in all I am lucky I am not a vegetable on life support apparently. I hope this helps someone- my doc has been in the game 45 years and never seen a bona fide case until now- and all the other doctors said exactly the same thing- they had often thought they had seen SS but inherently only ever extremely mild cases or the onset of the symptoms.
Stay saFE CATS.

 

[gnairn23]

Hi,

First I have to ask how can you be sure it was serotonin syndrome? Only tramadol and alcohol? Are you sure it wasn't a seizure from tramadol and not serotonin syndrome? Because what I know about serotonin syndrome usually you will get many other symptoms before you go to coma or collapse. Also I have never heard that tramadol and alcohol could cause serotonin syndrome anykind. I have been also drinking and taking tramadol big doses but no serotonin syndrome or anywhere close to that.

But I think I have some experience with serotonin syndrome (or I suppose so because of the symptoms) when I was using amitriptyline (TCA), tramadol and DXM. I was avare of that serotonin thing but my amitriptyline dose was low, only 20mg at night and I took evening DXM about 300-400mg and had no problems because I didn't use amitriptyline that night of course because I was aware that they might cause problems. Anyway.. that DXM trip was very strong and lasted long because I had drink grapefruit juice wich is my regular drink with food. Next morning when I was going to work DXM was still affecting me some way but I was thinking that there wasn't anymore much SNRI effect of DXM but rather dissociative effects of metabolite DXO wich I thought doesn't act as an SNRI. So I took my regular tramadol dose at that morning of 100mg.

But then about hour later things started to going scary...

At suddenly my heart started to racing wildly and my body temperature started severely raising. In few minutes my t-shirt was completely wet because I was sweating severely. I started having severe headache, nausea, shaking and tremors. I took xanax but it didn't helped much at all so at that moment I was sure it was something else than panic attack (wich I recognice and have been suffering many years) and I could only think it was because of too much serotonin. I think I had some hypertensive crisis at that time because I had also took ephedrine and coffeine but normally with tramadol they don't cause the problems I was having that day. My blood pressure is normally also kind of high but I wouldn't be suprised if it was something like 200/150 because my ear was also popping and really I fealt I'm going to die because I was also mentally little disorientated.

Anyway it started to ease in few hours and then I thought it might be safe to take my protein drink. I was little scared to take it because of high tryptofan content but anyway I took it. Well it was bad idea. I think the tryptofan in that protein shake increased serotonin and my symptomps get a lot worse. My headche came back, I felt dizzy, was panicking, had tremors and was shaking and sweating. Heart started to beating like a crazy again.

It was stupid to take that because my body told me by nausea that I shouldn't eat anything. Well by evening my symptoms started to get better but I still had ex. red skin when I went to sunlight (wich might have been also a stupid idea because sunlight might increase serotonin also) but anyway I decided to take some protein again (I am weightlifter). No bigger problems anymore with that. But then I wen't to my computer and thought to take some fruit juice. I was little hesitating with that because sugar also increases tryptofan content in brain especially when you have ingested protein before. So I was thinking long should I drink sugar containing drink after protein or not.. I decided to drink. And that was BAD idea.

I really felt that serotonin again increased massively because my headaches get a lot worse and my ears started to popping and heart racing and I was sweating like crazy. My vision also get somehow blurred and I got chest pains and nose bleeds. I really felt I had hypertensive crisis again and was scared and thinking to go ER.
Anyway it got better after an hour or two and by the evening I took clonidine and felt how my blood pressure went down and I got a little better.

After I had survived that I had same symptomps as you had: My mood was very low, I had panics, depression, lack of motivation, very bad fatigue, withdrawing from social situations etc. But after about two weeks I started to feeling about normal again.

I think you haven't permanently damaged anything. That was what I was also thinking but brains are very adaptive. I think it is the psychological thing wich makes a biggest problems - at least in my case.

Best luck to you anyway, try to stay optimistic. Your body and mind needs time to heal.

Edit: Oh, I forgot that drinking. It is what causes general anxiety disorder, panic attacks, deprsession etc. If you had been drinking excessively I would bet that there is the root of your anxiety problems and not the possibly serotonin syndrome. If you could tell me how are you sure you had serotonin syndrome? Did you have same kind of symptoms like I had before you passed out? Or how are you sure it was serotonin syndrome? Sorry I'm skeptical I don't mean to be rude but it just sounds very unlikely to me that only tramadol and alcohol would cause severe serotonin syndrome. But I could be wrong also.

Hello, This is a fantastic post, one of the most educated and well informed post i've read about chemistry. Anyways, Would you regard ssri drugs as safe to take when recovering from serotonin syndrome?