Serotonin Syndrome

[houswoea]

Okay, so I'm am the least medically-inclined person ever, and I'm trying really hard to make sure I don't make things worse for myself. It's not that I don't trust my doctors, it's just that they seem disconnected from every other part of my treatment, like they all have their own pieces and if it doesn't fit with what they want for me, they tell me to stop whatever the other doctor says.

So I finally got some pain meds, praise Jesus, and it's tramadol. I can't tell if I should be cautious about using it because I'm already taking a low dose of Prozac to see if I can lower my norepinephrine I'm scared that I'm going to get sicker... probably not like life-threateningly, but just not better and I want to be better! But My primary was the one to give the prescription, so I want to trust her, but I know we're all a little more sensitive to medication and I wanted to see if anyone has had trouble with it before? I don't want to just stop one or the other, but that's the only option they ever give me if I'm worried.

Thanks!

Liz

[dakota]

I think it's good that you are paying attention to meds interactions, because I'm not sure if sometimes the doctors do. My daughter was on Trazodone and Tramadol for an extended period of time and had no problem with serotonin syndrome, even though it is something to watch for with these two meds combined. When they tried to add a third one that also interacted in this way, we balked, and she was switched to something else. I think it's good to be aware of and watch for drug interactions, but my daughter had no problems with this.

[Guest tearose]

No, I don't have it do you?

I think with us we need to be extra cautious of 1) the med( we get odd reactions and sometimes have worsening of symptoms 2) any interactions with other meds or substances; like some herbs can interfere with a drug and 3) becoming tolerant and then needing more of it and then getting sick from that.

I hope you feel in balance soon!

[issie]

I do okay with Tramadol if I also take a muscle relaxer (Bentyl) with it. For some reason the combination really helps - not only the pain, but the POTS. I try not to take it every day. I average about every 3rd day. I want it to stay effective at a low dose and not have to keep upping it. So far, so good. Recently added .5mg propronalol. So far, so good on it too. Can't take more than the .5 though. Sometimes, take that 2x a day. Take the tramadol and bentyl usually at night - unless having a real bad day. Hope it works for you.

[houswoea]

Oh few, I'm just being a worry-wart. I can never really tell! They always make the labels sound so serious, and the doctors are always on the other extreme so I get scared

I like the tramadol, but I can see it would be very easy for me to get addicted! It makes me... um, happy? Or something? Even though I can still feel the pots, I just feel really okay with it. And sleepy.

[issie]

.

[Heiferly]

I take one med (for cataplexy associated with narcolepsy) that has serotonin activity daily. I have Tramadol available PRN for pain (also with serotonin activity) and both of my PRN acute attack migraine meds (not to be taken concurrently, they're an either/or thing where I choose which one is right for the type of migraine I'm having) also have serotonin warnings. My rule for myself is never to combine more than 2. The cataplexy medicine is taken last thing before bedtime. So, for example, the other day I took a Tramadol early in the day. Later that night I had a migraine and had to use my Sumavel Dosepro for my migraine. To avoid the potential of serotonin syndrome, I skipped my dose of Imipramine (my cataplexy medication) that evening and just recontinued it as normal the next day. My home nurse agreed with my judgment when she came to do my medications the next day and saw the skipped dose, so I think this is an acceptable strategy if you're uneasy about it (so long as it's a medication that you can miss doses of safely ... check with your doc or pharmacist of course if you don't know).

I also asked my pharmacist about it when I was Rxed more serotonin meds, because I was concerned that an awful lot of the symptoms of serotonin syndrome sounded like symptoms I already have (at least from time-to-time) with my dysautonomia. She reassured me that the severity of the symptoms and the onset of the symptoms in a cluster all together would likely alert me (and/or those around me) that something different than my "normal" was going on so we would know to go to the hospital. I think it's good to be aware of, and to be mindful of not heaping more and more serotonin meds on top of each other, but not something we have to totally panic about if we have to take two at a time.

[houswoea]

Yeah, taking tramadol has been like a nightmare that I can't wake up from... I can't sleep more than two hours a night, my muscle spaz out all over I can't really look at things because my eyes and head hurt so much and I have to force myself to eat once a day but I am just so sick it's like torture.

The pharmacist and the doctor say I should just deal, but I think I'd rather jump out a window or set my hair on fire than continue. It worse than all of my worst episodes combined.

But the doctor's solution was to up my dose of prozac because he thinks I'm nuts. Because I was freakin out because I haven't slept in like over week. So I'm not sure what to do. I feel like I will kill my brain if I take more, but I could be wrong... anybody ever go through this before?

[issie]

I have to add the bentyl (a muscle relxr) when I take the tramadol. I can't take either of them by themselves. The combo works good for me. I try not to take them every day.

As for the proprnalol - had to stop it - it made my blood pressure go up terribly when it started to wear off. I've been off of it for 4 days and am starting to feel better. At least I figured out that it was making me worse.

We know our bodies and sometimes things just don't work like they are supposed to - Its called a paradox reaction. Pay attention to YOUR body, you know what does and doesn't work for you.