Misc Serotonin Syndrome?/What Now?

over the course of four days i ingested multiple substances, and on the fourth day, i experienced something that closely resembled serotonin syndrome.

day 1: 100mg 5-htp/60mg adderall
day 2: 100mg 5-htp/20mg adderall
day 3: 100mg 5-htp/1 pill ecstasy/2 bowls weed
day 4: 100mg 5-htp/600mg dxm (robitussin cough gels)/2 bowls weed

the alleged serotonin syndrome began a few hours into the dxm trip. i've had prior experience with dxm and the symptoms that i experienced were distinct from those of the trip itself. i had extreme anxiety, an elevated temperature, feelings of influenza and confusion, visual disturbances, some muscle twitching, and a warm but extremely unpleasant pulsing/pressurized sensation running throughout my head, especially near the back of my neck. it's difficult to describe what i felt, but at the time, i was convinced that something horrible was happening. i had begun googling serotonin syndrome and was considering my options. luckily, however, i was able to fall asleep. i woke up the next morning feeling substantially better, but still feeling most of same symptoms, although they were much milder than they were the night before. throughout the course of the day, the symptoms slowly let up. when i awoke on the following morning, i felt fantastic, and had an excellent day. i decided to go out drinking that night (and took my fish oil supplements at night) and everything was fine, until i woke up the next morning with a high fever and extremely high anxiety. the symptoms that i experienced throughout that day and the next were comparable to those of a migraine. at this point, i am feeling much better, but i still have a few questions. it's been nearly a week since the initial incident, and i'm wondering if a.) it's safe to start taking my fish oil supplements again, and b.) if it's safe to consume alcohol. i'm not sure if what i had was actually serotonin syndrome, but if it was, is some sort of relapse possible, if i'm not careful? i understand how irresponsible this all was, and i still can't believe how absentmindedly i mixed these serotonergic substances. any suggestions would be much appreciated.

I'd just like to start off by saying yes, that was rather silly 8) But I'm glad yer ok
With SS, I'd suggest playing it as safe as possibly - Stay away from most substances for atleast another week or until you're feeling normal (or as close to normal as you usually feel).

It will have been the drinking, rather than the fish oil supplements, that made you feel like death that next day so I think you'd be ok to take those.
But stay away from most, if not all substances for another week or so (as suggested) and then next time - be more careful

IF you truly had SS, (which is actually much rarer than people think....many people make the assumption that SS is what they were dealing with, when in most cases, it was something else...)then you need to be VERY careful. IF you ever experience these symptoms again and suspect SS, don't mess around...head to the ER as it is a medical emergency and can easily be lethal. Also, this way, you can get confirmation (or not) of what you're dealing with.

It's rather likely that s/he did experience SS..
Amphetamines + Something passing for MDMA in a pill + DXM = Serotonin mentalness / fuckupery / Syndrome.
And considering this all happened after s/he took the DXM which has SSRI-type effects (either that or SRA, cannot remember which one for certain) makes the cause-compass point fairly firmly towards SS.

So yes, I'd definitely reinstate your and my suggestion to be very careful about what you take over the next week or so (better that it be nothing / barely anything).

happygoluckygal said:

IF you truly had SS, (which is actually much rarer than people think....many people make the assumption that SS is what they were dealing with, when in most cases, it was something else...)then you need to be VERY careful. IF you ever experience these symptoms again and suspect SS, don't mess around...head to the ER as it is a medical emergency and can easily be lethal. Also, this way, you can get confirmation (or not) of what you're dealing with.

Click to expand...

the symptoms they described are definitely consistent with SS and very similar to all the symptoms i experienced with my short dealing with it - fucking terrible disgusting kill me nao shit it is. i had valium (and codeine) to help out with the agitation, which is what is used in hospital setting; benzodiazepines.

monstanoodle summed it up pretty well i think, i'd be very careful with what else you consume over the next week or two. steering clear of any drugs, particularly SERT heavy drugs, would be wise.

The mind can be very powerful. I haven't been feeling well today at all and pretty much have the same symtoms as you. I have a slight fever, anxiety, etc. I read the symptoms and now I believe I have it too! Today I took my 1.5 mgs of subutex and 20 mgs of my ritalin. Is it possible that this is why I don't feel well?

no, you don't have serotonin syndrome. buprenorphine and methylphenidate have no such interactions.

I had seratonin syndrome but it was MUCH worse than what you described...it sounds like you just had a bad reaction to all the consistency of drugs.

Why so much 5-HTP?? I really dont see how this serves a purpose, and always thought 5-htp was really just a joke in general (ive done it many times, along with melatonin, its such a waste of money), and why do 5-htp on the same day you rolled? It seemed to weakon the effects when I did that

I did fish oil for a long time, but after letting my body recover and getting panic attacks constantly I was put on anti psychotics for a while, then switched to SSRIs which my drug therapist recommended for resetting my seratonin receptors back to normal (I used to binge on mdma) and it was a life saver.

Take a break, and see what happenes, but I think u'll be fine.

It sounds like you may have had a mild version of serotonin syndrome. All the drugs you mentioned modulate serotonin in one way or another, with DXM probably having the most significant effect. When you combined the 5-HTP with these drugs, it increased the amount of serotonin your brain could use as well as the drugs forcing even more serotonin back into the synapse thus creating a massive increase of the chemical.

Since it's been a week, you should be fine to move back to all of your supplements. Just be cautious though, you shouldn't combine 5-HTP with drugs that do effect the serotonin system, it could create a more dangerous overload next time and you could end up with a more acute version of serotonin syndrome. Just watch what you combine 5-HTP with, that's ultimatelly the trigger in most cases or SSRIs.

^indeed it is to a certain degree - 5htp being mixed with other pharmaceuticals. certain srni/ssri combinations mixed with contraindicative meds is high up on the list in my experience.

i was on 5htp supplements and mentioned it to my doctor and he was unaware of the adverse reactions whilst on tramadol for pain mangement as well as oxy - though no interactions between oxycodone and 5htp obviously.

i had to bring him in studies and contraindications cites from studies to settle his mind so as to not continue me on the tramadol whilst i was using the supplement.

if in doubt there's no harm in questioning your doctors suggestions, bringing in information contradicting the combo of meds he may have you on. it also helps build a doctor/patient relationship trust between each party which will go a long way in your relationship with each other.

thanks for the replies, this is all extremely helpful information. i'm going to start up the fish oil again, but i might just drop the 5-htp altogether. although it was awful, at least this was a learning experience...i'm going to be much more conscious and careful about what i put into my body.

I think the OP have left me a little scaried about my plans of mixing ritalin with dxm.

You seem to know what caused your effects. Id stay away from the 5htp because these "syndrom" effects probably would not have happened if you had stayed away from them

CotoCole said:

I think the OP have left me a little scaried about my plans of mixing ritalin with dxm.

Click to expand...

That sounds like a God awful combination, but should not have much risk of serotonin syndrome; methylphenidate is not a serotonin heavy substance.

See this thread for people's experiences combining stimulants with DXM, including methylphenidate.

A quick search also gave me information that methylphenidate and DXM do not have any metabolic interactions so you are clear to go there.

See this thread for people's experiences combining stimulants with DXM, including methylphenidate.

Click to expand...

That thread left me with mixed feelings about the combination. Anyway, it sounds relatively safe and somebody there enjoyed.
Since some thread I recently started about the matter got promptly closed, I should shut up now.

I guess in the end it is a personal choice, and personally it's a combo that I wouldn't want to experience just incase.
It's the Adrenal bizniz that worries me to be honest.

seratonin syndrome is fuckin scary...a couple of years ago i managed to pack a bunch of seratonin-increasin drugs into a long weekend, freak out, and visit the ER doc to be prescribed an unusually large starting dose of fluoxetine...needless to say this made everything worse. my roommate at the time still tells a story of me telling her: "i feel like i'm going crazy, i can't see straight and i'm sweating a lot...i'm gonna go drive around."

next time be more careful, you only get one brain!