[mzdraggin]

Here is a interesting subject that I can say I survived?
I was treated for Acute Serotonin Syndrome in ICU for 13 days in Feb.-March 2007 as a result of a major ERROR.
I have a few questions about the treatment that was administered to me that seemed to have extended my recovery.
I do need to state that I DO NOT DRINK ALCOHOL. I am very proud to say I have been sobar 8 years

This started with a gross error when my doctor had me stop Prozac 40mg daily (on prozac 4 years) and start Effexor XR with NO washout period.
I was also on Fentanyl 75 patches for almost 10 months.
After only taking two Effexor pills with in a 48 hour period I was rushed to ER.
ER determine I did have Acute Serotonin Syndrome.
I was given cyproheptadine = serotonin antagonist and several Ativan injections.(fentanyl patch removed)
I was transfered to ICU and that doctor STOPPED the cyproheptadine treatment after 24 hours because there was no change in my condition (should have stopped with in 24 hours)
The doctor changed my treatment because he strongly believed that I was going through Alcohol DTs.
Over the corse of 3 days he had me treated with Ativan, Haldol, Versed ,and Morphine for pain.
I ended up with respiratory failer and was incubated for 7 days.
My husband, close friends told the doctor I DO NOT DRINK. In his notes he states this but also states he believes I was a "Closet Alcoholic"
Now here is where I am having alot of trouble understanding my treatment?
My lab work and other test should have been able to show my condition and the changes in my labs everyday (few times daily) with all the different drugs I was being injected with.
Being on Fentanyl, Prozac for so long, my system should still have these in because of how long it takes to wash out, and when stopping you should be weened?
The symptoms from suddenly stop taking Prozac,Fentanyl and the Serotonin Syndrome, plus the interactions of all the meds given to me because of my altered consciousness, confusion, myoclonus, ataxia, hyperpyrexia, shivering, pupillary dilation, diaphoresis, and hypertension? I guess what I am looking for is what went wrong with my treatment? What could have been done to prevent it from being prolonged and of course it manifested?
I realize that this is a subject (Serotonin Syndrome) that is hard to find alot of information about, find cases to read about and there are none that seem to compare to what I went through.
Any Thoughts? Questions?
I would be interested in hearing any.

[krissybaby]

Wow thats quite a story! Thank goodness you are here to share it with us! I have heard of Serotonin Syndrome. The thing is that most ER physicians are not aware of it b/c it can resemble drug withdrawls. I really think that if you had a washout period from the prozac this probably wouldn't have happened. Sorry wish I knew more..

Krissy

[elizabethmaria]

Hi!
Sorry to read about your awful experience - unfortunately, went through the same thing myself, though not as bad. Was on amitryptyline a bit for help with sleep, was having reaction, was misdiagnosed as some kind of brain problem (though it was obvious now that I was reacting to the ssri ) put me on trazodone, celexa and xanax for 3 days on top of that -no thought as to it already being in my system.. ended up in the hospital ER.. but fortunately they just stopped everything, as I had just started -thank HEAVENS... but, I know the pain -- and they're like, 'what happened'..! yes, they grossly misdiagnose this - thought I also had some major depression/crazy head thing going on.. though I NEVER had mental problems in my life, and only was originally prescribed ami because of sleep due to a different health issue... Unfortunate that they are so unaware - and am so sorry for all you have been through, that sounds terrible! I hope that you are recovering now.. I still have seizures/dystonia etc. from my reaction.. but sloowwwly improving
take care,
EM

[mzdraggin]

EM,
May I ask you if you have any memory of ER and the hospital?
I have tried and tried and I have no memory of being taken to ER, and not really much memory of being in the hospital.
I can recall being wheeled in a chair to the room I was in after leaving ICU (but I did not know it was ICU)
I can recall my husband comming in to see me in that room, but when and what day it was I can not recall?
I don't even have much memory of being discharged, But they allowed me to discharge myself?
My girlfriend that took me to ER, was my representative because I was not aware of person, place, date etc.
The hospital never even called her or my husband for that fact to notify of my discharge?
My husband suffered from TBI in 2001 and ask the hospital to keep my friend as my representative / point of contact because he was afraid that he would not be able to make the right chioces for me. So my friend worked with my husband through it all.
It took me a few months to get myself to think right, my short term memory was off, but that is getting better.
I just can not understand why the doctor at the hospital would use so many different drugs on me with out looking at the whole picture?
My medical records even show I suffered a "Adverse Effect Anticonvulsant"
It was bad enough that I suffered a ADE from my family doctor that placed me in ER to begin with (was family doctor 18 years) WAS!
But to read what the doctor in charge of my care in the hospital did to me? (He was VERY BIOS)
I just can not express how I feel.

[elizabethmaria]

Hi,
Again, I'm so sorry for what you've had to go through... I don't have much memory of that time, and very scattered memory from the weeks that followed. This, I believe, is very normal for a brain injury - since having seizures from the damage caused, it has also affected much of my memory and thinking since then - I don't have much of a sense of time and place, that still comes and goes. However, things are slowly improving, with ups and downs. I was almost in a coma state when I went to the hospital, if you were there, then I'm sure you wouldn't have memory of it - I don't think one would even want memory of it either! I'm sure parts of our brains shut down to protect ourselves, or were so damaged and couldn't hold memory well.. But it does get better, it just takes a long time to heal. I understand about the family doctor thing too - that's what happened to me, and yes, am changing the doctor!! It was amazing, after I was in the ER, then was out, the next day my family took me to see my reg. doctor, and she wanted me to stay on Celexa!!! good grief, so absolutely clueless, it is really really really sad. Prayer carried us through though, if I had taken that, I either would have gone into a full coma state, total seizures, or permanent brain damage, or committed suicide but my guardian angel was looking out after me I know. My family was like, celexa, for WHAT?? she's not depressed, never was, just trouble sleeping due to a totally different health condition! Shocks me so much, and it is really too scary to think about how close it was, I try not to think about it, just leave it in God's hands.. over time, we'll heal of the shock, and be thankful for having been so protected and survived to help others through our knowledge and experience... everything happens for a reason. Already, I have helped others, both friends, and even in my own family, by educating them on the dangers of these drugs, and comforted them as they had some scary side effects - and even convinced one person who was prescribed lexapro NOT to take it, as she didn't even want it in the first place... who knows how much anguish people will be spared!
As you get better, and feel stronger, I think it is vital to get more information on serotonin syndrome, research, and take it back to your hospital, doctor and ER and educate them. I know I'm not strong enough yet, but the time will come, and it really is our duty in a way if we can, because it very well may save someone else's life.. even the process of recovering, going back to your doctor, telling them again and again what happened, helps make them aware -- they are probably very very ashamed inside as to the extent of their mistake, and don't want to admit it - but the info will help someone else nevertheless...
Hope that you continue to recover well! Lots of healthy food, and prayer, and obviously being drug free is the best medicine !

You've probably already found this site, but if not, it's an excellent site for people recovering from serotonin syndrome/ssri reactions like us - plus lots of basic info on antidepressants themselves, how they work, etc.. It's at www.antidepressantsfacts.com make sure the spelling is exact) and the reaction recovery page is at www.antidepressantsfacts.com/reaction.htm
take care, love,
EM

[beelzibub]

Hi to all,
Noticed your topic, I have been through it and due to the fact that no medical assistance was given I have been left with many serious problems.
I understand you are not altogether too happy with the treatment/diagnosis, rightly so.
Anyway, just a bit of info relating to issues you've raised -; "adverse effect anticonvulsant" - what they have done...used the warning issued by the FDA in 2005 re:fentanyl blood levels can rise to toxic levels in certain circumstances and/or alter the characteristics of some medications. You don't mention a anticonvulsant?
Do you have the medical records that show the list of symptoms and the diagnosis SS?
If you are in the States you have options available but as you say it's obtaining the info.
If you need help or anything just let me know, sorry I'm not in the US.

[violinnurse]

Hello,

I know it's been a while since this subject has been discussed.

I had a baby in October -- and was put on sertraline a week after delivery because I was exhibiting signs of PPD (it was my 3rd baby, and I had a history of severe PPD following the first two deliveries). I began to feel better within a few weeks, and the doctor continued to titrate my dosage up as I told him how much better I was feeling. The dosage was up to 150 mg by mid-December. At this point, I was still seeing my OB/GYN for transient post-partum hypertension since I had elevated BP's at my 6-week postpartum checkup. Everything seemed fine, overall -- with the exception of the BP issues.

Then, in February, I began to experience dizzy "spells". I just shrugged them off, as they were just a nuisance. Then, two months later, the dizziness became debilitating, and I developed nystagmus (involuntary eye movements). A couple days later, my body was jerking involuntarily and my reflexes were unusually brisk. There was also excessive sweating, nausea, and some "minor" memory loss. I am a nurse -- so checked my BP while at work when I felt particularly miserable. It had gone up to 197/117! I somehow made it home from work (shame on the charge nurse for not sending me directly to the ER when noticing how badly I was doing!). When I got home, I was confused and did not make sense when trying to talk to my family. My husband, a pharmacy student (talk about Providential!), recognized I was in serious trouble. He contacted a pharmacotherapist at his school (who specializes in psychotropic drugs and has treated many women with postpartum depression), who told him I perfectly fit the criteria for acute serotonin syndrome. My husband then contacted my OB/GYN and shared his findings. Thankfully, my doctor is a humble person who is open to such things. He decided to wean me off the sertraline and start Buproprian instead.

While I am much better off than a week ago, I still feel pretty messed up. I am experiencing intense dizziness, feel like I am "drunk" (though not drinking at all!!!), and am struggling with some numbness in my tongue, lips, fingertips, and various other spots. I am still having problems with myoclonus and tremors -- especially when at rest.

Has anyone else out there struggled like this??? I am grateful to be on the mend -- but am discouraged at how long it will probably take to recover (the specialist my husband spoke with told us to expect it to take 6-8 weeks). I feel very alone since this syndrome is so rarely discussed by physicians -- and seems overwhelming to those who have little/no experience with it. I feel that I should be monitored somehow -- as the symptoms are still pretty severe (at least my brain is back, and I'm not confused anymore!). My physician is likely unaware of how badly I feel -- but if I called to let him know how poorly I was doing, what would be done? I know that this is a very tiring process for those who are taking care of me -- but I must be more tired of it than ANYONE!

Thanks for "listening".