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Talarico, 2011 Serotonin toxicity: a short review of the literature and two case reports involving citalopram.


Jemima
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Neurol Sci. 2011 Jun;32(3):507-9

Serotonin toxicity: a short review of the literature and two case reports involving citalopram.

Talarico G, Tosto G, Pietracupa S, Piacentini E, Canevelli M, Lenzi GL, Bruno G

 

Abstract at https://www.ncbi.nlm.nih.gov/pubmed/21491099  Full text requested

 

The serotonin toxicity (ST) is a potentially life-threatening adverse drug reaction results from therapeutic drug use, intentional self-poisoning, or inadvertent interactions between drugs. ST can be caused by a single or a combination of drugs with serotonergic activity due to excessive serotonergic agonism on central nervous system and peripheral serotonergic receptors (monoamine oxidase inhibitors, tricyclic antidepressants, SSRIs, opiate analgesics, over-the-counter cough medicines, antibiotics, weight-reduction agents, antiemetics, antimigraine agents, drugs of abuse, H2-antagonist and herbal products). The serotonin toxicity is often described as a clinical triad of mental-status changes (agitation and excitement with confusion), autonomic hyperactivity (diaphoresis, fever, tachycardia, and tachypnea), neuromuscular abnormalities (tremor, clonus, myoclonus, and hyperreflexia) and, in the advanced stage, spasticity; not all of these findings are consistently present. In this article, we describe two cases of ST due to interaction between Citalopram and two CYP2D6 inhibitors: Cimetidine and Topiramate and their clinical resolution after treatment discontinuation.

Edited by Altostrata
updated

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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Jemima,

Very interesting topic. I haven't read entire article yet but suspect that Serotonin Syndrome/toxicity is far more prevalent than generally reported.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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I have not read this particular article, but am aware of ST. That is why I got rid of the Tramadol I was prescribed for pain. It can cause ST in combination with Effexor XR...both drugs mess with Serotonin re uptake.

 

Daisy

Effexor XL 2009-2012. CT 150mg Effexor XR  2012, Effexor XR  75mg  2012  then rapid taper to 0, Reinstated Effexor XR 13mg then updosed to 20mg, Tapered to 18mg Effexor XR 4/9/12, Off Effexor XL ?Reinstated  Effexor XL 150 mgs  August  2012, Crashed in November 2012, Prozac 40 mgs 2012 to Feb 2018, Buspar 60  mgs 2012-stopped 2015, Remeron 7.5 mgs as needed for sleep-stopped Feb 2017, Prozac 50 mgs Feb 2018 to March 2018, Lexapro 5 mgs March 18 2018 to May 17th 2018, Lexapro 2.5 mgs  May 18th to May 26th 2018, Prozac 10 mgs May 15th 2018, Prozac 5 mgs May 19th 2018 to current day May 28th 2018,  Xanax 0.25 mgs to 0.5 mgs daily for over 15 years. Increased Xanax to 1.5 mgs Sept 2012, Tapered Xanax to 0 mgs  May 2013.Reinstated Xanax Feb 2017 at 0.125 mgs as needed, Gradual increase of Xanax to 1.5 mgs daily till May 22nd 2018, Xanax 1.25 mgs daily. Holding

 

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I have not read this particular article, but am aware of ST. That is why I got rid of the Tramadol I was prescribed for pain. It can cause ST in combination with Effexor XR...both drugs mess with Serotonin re uptake.

 

Daisy

 

Did the same doctor prescribe them to be taken at the same time?

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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Correct, this is also known as serotonin syndrome, a very serious adverse effect long documented in the medical literature.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Jemima

 

The Doctor that prescribed the Tramadol knew I was on Effexor XR. Alto is the one that informed me about the Tramadol.

Effexor XL 2009-2012. CT 150mg Effexor XR  2012, Effexor XR  75mg  2012  then rapid taper to 0, Reinstated Effexor XR 13mg then updosed to 20mg, Tapered to 18mg Effexor XR 4/9/12, Off Effexor XL ?Reinstated  Effexor XL 150 mgs  August  2012, Crashed in November 2012, Prozac 40 mgs 2012 to Feb 2018, Buspar 60  mgs 2012-stopped 2015, Remeron 7.5 mgs as needed for sleep-stopped Feb 2017, Prozac 50 mgs Feb 2018 to March 2018, Lexapro 5 mgs March 18 2018 to May 17th 2018, Lexapro 2.5 mgs  May 18th to May 26th 2018, Prozac 10 mgs May 15th 2018, Prozac 5 mgs May 19th 2018 to current day May 28th 2018,  Xanax 0.25 mgs to 0.5 mgs daily for over 15 years. Increased Xanax to 1.5 mgs Sept 2012, Tapered Xanax to 0 mgs  May 2013.Reinstated Xanax Feb 2017 at 0.125 mgs as needed, Gradual increase of Xanax to 1.5 mgs daily till May 22nd 2018, Xanax 1.25 mgs daily. Holding

 

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Jemima

 

The Doctor that prescribed the Tramadol knew I was on Effexor XR. Alto is the one that informed me about the Tramadol.

 

AGH!!! We really are on our own when it comes to medical care. I've met more doctors who have no idea what they're doing in the past two years than I care to describe. :angry:

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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  • Altostrata changed the title to Talarico, 2011 Serotonin toxicity: a short review of the literature and two case reports involving citalopram.
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