Posted by PsychoSage on April 5, 2004, at 20:14:37
In reply to Re: effexor/E --MORE LINKS serotonin syndrome, posted by PsychoSage on April 5, 2004, at 19:57:30
> http://uuhsc.utah.edu/poison/healthpros/utox/Vol4_No4.pdf
>
> looks to me like they both increase serotonin however you want to look at it.
>
> I found the same information that is in this thread that says that it is a waste of money to roll on an SSRI on a website called bluelight that promotes drug experimentation, and it's heavily flawed. Some poster produced a lengthy list of potential drug interactions between psych and recreational drugs, and it's truly laughable.
>
> Anyhow, it's true that a lot of serotonin syndrome cases resolve themselves, but it's still an unpleasant experience. You also don't want to be in that group of people who end up in a coma.
>
> All I truly know from my experiences several years ago is that EFFEXOR +METH = my death. I was really ignorant because i knew what Serotonin Syndrome was, but I just equated it with MDMA. I avoided MDMA while I was on Zoloft, so I never knew that particular combination and its subsequent displeasure. I had no clue that meth was serotonergic also, and that contrast highlights the difference between it and cocaine.
>
> I have plenty of experience with piling on the noradrenergic and dopaminergic fun stuff, and that did not do my body any good, but it did not make me emergency room material.
>
> Lastly, for the layperson it makes simple sense. Effexor has been implicated in many serotonin toxicity cases with or without MDMA. MDMA has definitely been implicated in a lot of serotonin toxicity cases. If you take them together, I think they would kick your but.
actually, cocaine does have effects on serotonin I have just learned, but hat's not pertinent for most of us I hope.
Mechanisms of increased serotonergic activity and representative drugsIncreased synthesis
L-tryptophanDecreased metabolism
Monoamine oxidase inhibitors
Phenelzine
Tranylcypromine
Moclobemide
Selegiline
IocarboxazidSerotonin receptor agonism
Buspirone
Sumatriptan
Lysergic acid diethylamide (LSD)
LithiumIncreased serotonin release
Amphetamines
Amphetamine derivatives
Fenfluramine
Phentermine
3,3-methylenedioxymethamphet-
amine ("ecstasy")
CocaineInhibition of serotonin reuptak
Nonselective inhibitors
Tricyclic antidepressants
Meperidine
Dextromethorphan
Cocaine
Amphetamines and their derivatives
Selective inhibitors
Sertraline
Fluoxetine
NefazodonePerhaps this is what I experienced. Either way it was toxic, and I don't want to go back there. Serotonergic or sympathomimetic, it's asking for seizure, stroke, and coma.
http://www.findarticles.com/cf_0/m0BPG/12_17/96058312/p10/article.jhtml?term=prednisone+%2BAmine
Sympathomimetic poisoning syndrome
Substances that have mainly sympathetic stimulant activity are used
widely both in therapeutic and recreational settings. Catecholamines
are the main ingredient of over-the-counter cold remedies. Appetite
suppressants are mostiy sympathetic stimulants. Recreational use of
psychostimulant drugs, such as cocaine, and amphetamines and their
derivatives is widely prevalent. Amphetamines, methamphetamines and
so-called designer drugs have replaced cocaine as the recreational
drugs most frequently abused in the United States. Other illicit
substances with sympathomimetic activity include LSD and phencyclidine
(PCP).Cocaine acts predominantly by inhibiting the reuptake of
norepinephrine, serotonin, and dopamine into presynaptic vesicles. As
noted above, amphetamines and methamphetamines stimulate the release
and inhibit the reuptake of not only serotonin but also norepinephrine
and dopamine. Although they are chemically different, sympathomimetics
such as cocaine and amphetamines produce similar clinical
presentations.Hyperthermia is only one of the many systemic manifestations
associated with use of these drugs, especially in moderate to severe
poisoning. The mechanism of cocaine- and amphetamine-induced
hyperthermia is unknown, but most likely it is related to disruption
of thermoregulation by the CNS, excessive muscular activity, increased
metabolic activity; and elevated ambient temperature. The role of
ambient temperature has been shown in animal and human studies.Marzuk and colleagues (20) demonstrated an increase in mortality rate
from cocaine overdoses when the ambient temperature was 31[degrees]C
(88[degrees]F) or higher. Conversely, in rats given methamphetamine,
hyperthermia and death are prevented by a hypothermic environment.
(21)Patients with sympathomimetic poisoning syndrome usually are brought
to the ED agitated, confused, and combative. Seizure is not an
uncommon presenting symptom. Detection of hyperthermia is often
delayed while the patient is evaluated and airway, breathing, and
circulation are stabilized. The temperature can continue to rise as a
result of agitation and fighting of restraints. Hyperthermia is likely
a marker of severe poisoning and has been associated with the many
complications involving organ tissue damage, such as rhabdomyolysis,
renal failure, DIC, acidosis, and liver injury. (22)Diagnosis is suspected from the history of drug use and confirmed by
toxicology studies. In addition to agitation and delirium, patients
with this syndrome frequently are diaphoretic, with dilated but
reactive pupils. Bowel sounds usually are present and may be
hyperactive. Tremors and rigidity have been described. (22)
Differentiation of sympathomimetic poisoning syndrome from other drug
toxicities, such as serotonergic and anticholinergic toxicities, will
be aided by the medication history, but in the case of drug overdoses,
such information is frequently unavailable.As the patient is stabilized, aggressive cooling measures, including
sedation and, if necessary, neuromuscular relaxation, should be
instituted in the ED to stop continued increases in body temperature.
Nondepolarizing muscle relaxants and dantrolene have been used
successfully. Benzo-diazepines are used to treat delirium and
agitation. Seizures typically are not responsive to phenytoin and are
best treated with benzodiazepines. Tracheal intubation and mechanical
ventilation may be required for several days. Close monitoring for
organ system dysfunction is mandatory.
poster:PsychoSage
thread:332813
URL: http://www.dr-bob.org/babble/20040402/msgs/333087.html