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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by joema on June 25, 2001, at 14:35:30
I'm a 43-yr old male with a 4mm prolactin-secreting benign pituitary tumor called a prolactinoma. I take 0.5mg/week of a dopamine agonist med called Dostinex (Cabergoline), which controls my prolactin level and prevents the tumor from growing.
I also have mild depression/anxiety, for which I'm trying various ADs. When I took 150mg of serzone, within 2 hrs I had hypomania, diaphoresis, shivering, 102 temp, nausea, blurred vision, marked flu-like symptoms. It gradually abated over 24 hr.
Are there known drug interactions between dopamine agonists and Serzone? Did I have serotonin syndrome, or just individual sensitivity to a (maybe too high) starting dose?
Can I start at a much lower dose of serzone (say 20 mg), and just very slowly increase? Are there risks to doing this given the above?
-- joema
Posted by joema on June 25, 2001, at 14:47:31
In reply to Serzone + Dopamine Agonist = Serotonin Syndrome?, posted by joema on June 25, 2001, at 14:35:30
BTW when I took Serzone, I'd taken no other prescription or OTC meds (besides Dostinex) within two weeks.
Also I've tried Zoloft (sexual dysfunction), Wellbutrin (insomnia, no improvement), Remeron (weight gain, no improvement).
So that's why I'm trying Serzone.
-- joema
Posted by anita on June 25, 2001, at 15:54:30
In reply to Serzone + Dopamine Agonist = Serotonin Syndrome?, posted by joema on June 25, 2001, at 14:35:30
Hi Joema,
It would seem to me that it would be unlikely that serotonin syndrome could be your problem, although your symptoms match the diagnosis. I would guess that you started at too high a dose of Serzone (I started at 50mg). On the other hand (and this is only theoretical), Serzone as well as dopamine agonists increase noradrenaline, so perhaps you had something like a noradrenergic crisis. Did you have a fast heartbeat and headache?
Only your doctor would know if you should try the Serzone again at a lower dose.
Good luck,
anita> I'm a 43-yr old male with a 4mm prolactin-secreting benign pituitary tumor called a prolactinoma. I take 0.5mg/week of a dopamine agonist med called Dostinex (Cabergoline), which controls my prolactin level and prevents the tumor from growing.
>
> I also have mild depression/anxiety, for which I'm trying various ADs. When I took 150mg of serzone, within 2 hrs I had hypomania, diaphoresis, shivering, 102 temp, nausea, blurred vision, marked flu-like symptoms. It gradually abated over 24 hr.
>
> Are there known drug interactions between dopamine agonists and Serzone? Did I have serotonin syndrome, or just individual sensitivity to a (maybe too high) starting dose?
>
> Can I start at a much lower dose of serzone (say 20 mg), and just very slowly increase? Are there risks to doing this given the above?
>
> -- joema
Posted by joema on June 25, 2001, at 19:56:38
In reply to Re: Serzone + Dopamine Agonist = Serotonin Syndrome? » joema, posted by anita on June 25, 2001, at 15:54:30
Anita said:
"...perhaps you had something like a noradrenergic crisis. Did you have a fast heartbeat and headache?"Yes, I also had a bad headache and a fast heartbeat. Except for the mental euphoria (everything was funny) and the blurred vision, it physically felt like a bad flu -- shivering, aching, fever, headache. I'd read flu-like symptoms are possible with ADs, but never dreamed it could happen so fast or so severe.
I found a couple of anecdotal reports saying dopamine agonists plus ADs can cause serotonin syndrome. However I can't find any research paper on Medline mentioning that.
I think I'll re-try Serzone, starting at a very low level.
Thanks for the comments.
-- joema
Posted by chiaratara on June 30, 2001, at 2:14:37
In reply to Serzone + Dopamine Agonist = Serotonin Syndrome?, posted by joema on June 25, 2001, at 14:35:30
I found those to be the side effects of serzone. Flu like symptoms and just feeling "out of it."
I tried serzone for about a month and stopped because it was much too sedating. I started at 50 and then wound my way up to 150. I had similar symptoms when I started on 50mg. I didn't go to work for three days and didn't drive because I would literally space out for seconds and not remember things.
One story, about a week into taking serzone, I was in a parking lot waiting for someone to pull out of a spot, so I could pull in. The next thing I knew, I was parked in a different spot. Serzone made me quite loopy, and the symptoms you are describing are not unusual in my opinion, however, i am not a doctor. Is the same doctor prescribing both drugs? If not, run it past your doctor. If the DR gives it the all clear, I would not doubt that your symptoms have to do with Serzone.
I even had the blurred vision and went to actually thought my vision had changed dramatically in the course of a few days. Tricky stuff.
The started pack I received from my doctor contained gradual dosing, which is probably a big hint that you should start out with a smaller dose and work your way up. The starter kit was from the drug company.
I hope it is helping.> I'm a 43-yr old male with a 4mm prolactin-secreting benign pituitary tumor called a prolactinoma. I take 0.5mg/week of a dopamine agonist med called Dostinex (Cabergoline), which controls my prolactin level and prevents the tumor from growing.
>
> I also have mild depression/anxiety, for which I'm trying various ADs. When I took 150mg of serzone, within 2 hrs I had hypomania, diaphoresis, shivering, 102 temp, nausea, blurred vision, marked flu-like symptoms. It gradually abated over 24 hr.
>
> Are there known drug interactions between dopamine agonists and Serzone? Did I have serotonin syndrome, or just individual sensitivity to a (maybe too high) starting dose?
>
> Can I start at a much lower dose of serzone (say 20 mg), and just very slowly increase? Are there risks to doing this given the above?
>
> -- joema
Posted by joema on June 30, 2001, at 4:55:11
In reply to Re: Serzone + Dopamine Agonist = Serotonin Syndrom, posted by chiaratara on June 30, 2001, at 2:14:37
Chiaratara:
I've discussed both drugs (Dostinex & Serzone) with my Dr. His thinks since Dostinex is a dopamine drug and Serzone is serotonin + norepinephrine, there's no conflict. However I found this web page saying dopamine agonists + SSRIs (which Serzone technically is) can cause serotonin syndrome. http://www.uspharmacist.com/NewLook/DisplayArticle.cfm?item_num=94.
I've resumed serzone at a very low level, ramping up very slowly. 20mg/day at first, now up to 60mg/day. No major problems so far, although it stimulates me so I have insomnia. Feels like I drank black coffee. I'll discuss further with my Dr. in two weeks.
-- joema
> Is the same doctor prescribing both drugs?
> If not, run it past your doctor. If the DR
> gives it the all clear
This is the end of the thread.
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