I have been taking Lexapro for about 6 years now, and in the past year I have experienced some very strange occurrences. The first time was after smoking about a gram of cannabis across a period of three hours. I felt panic and like I was going to throw up or pass out, not knowing which it was going to be I headed to the bathroom. As soon as I saw the mirror I saw colorful lights flashing across the mirror (i have never taken psychedelics but I would relate this to what I've heard about them), I spun around and lost consciousness for a few seconds. I stopped smoking for a while after this..
About six months later I was having a few beers with my family; I was trying to be carfull, only drinking one beer an hour. When I was halfway through my third beer (in the third, perhaps fourth hour) I got up to get something to drink and felt a surge of energy rush into my head: it felt like it was lit up with lights. I laid down and the next morning I was fine. Again I stopped drinking for a period of time. But then, about two months later when I drank about 4 glasses of wine at thanksgiving I did not have any problem.
My last occasion was again with Cannabis, but I only had two hits and after watching tv for thirty minutes, my heart began to race and I started having a panic attack fearing I would have a heart attack. I took deep breaths to try to calm myself down. Once my heart was at a more normal pace my legs began to twitch violently and stopped a couple minutes later. I felt weird the rest of the night and I didn't smoke anymore.
After all this explanation, I want to know if you (doctors) think I could have serotonin syndrome? Does it simply pass or is it a life-long condition?
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7 Answers
BU
Bunsdad
3 May 2017
I have withdrawn from effexor twice. It is rough for two days but I alwys found that my body knew when it was finished with the drug. You start to feel like you are withdrawing while you are takimg it so stop them...
Votes: +0
KH
kh90
5 April 2015
I think it IS serotonin syndrome, but it was a mild case (I kinda think that serotonin syndrome would occur on a continuum, and not always producing multiple life threatening symptoms). I have consumed cannabis while taking an SSRI, Zoloft, and experienced some of the symptoms of serotonin syndrome; anxiety, twitching, palpitations, tachycardia (well, my heart rate was 118) dry eyes, labile blood pressure, restlessness and feelings of detachment. The first time it happened it lasted for about two hours, maybe longer. (FYI Cannabis, or rather THC does not directly effect the serotonin receptors, but other cannabinoids do, like cannabidiol (CBD) which affects the serotonin 1A receptors, and antidepressants eventually cause a decrease in the number of these serotonin 1A receptors. I wondered about this when I tried cannabis again some time later, when I thought my body would have adjusted to the antidepressants.
I felt like I had the first time I mixed cannabis and Zoloft, and I decided to try taking a Buspar because it an antianxiety, and because I didn't know what else to do; about 20 minutes later all the effects of the cannabis were very muted, it was almost like I hadn't consumed the cannabis at all. Buspar is a serotonin 1A receptor partial agonist, CBD is an agonist as well. CBD also antagonizes the euphoric and anxiogenic effects of THC in cannabis. In other words, I think the Buspar synergistically interacted with CBD and mitigated all the effects of the cannabis. The Buspar, being a short acting serotonin blocker (only a partial agonist at 5HT1A) that greatly reduced the classic symptoms of serotonin syndrome, it seems likely that cannabis could interact to a limited extent with an SSRI and cause a mild excess of serotonin, hence some of the symptoms of serotonin syndrome. I'm not a docor, but you asked if it was a life long condition, well, no. You just have to choose between cannabis or Lexapro, and probably the other SSRI drugs. There is a new SSRI/5HT1A partial agonist drug, Viibryd, it does like your Lexapro does, but it also does the same thing that Buspar does, you could try taking that and seeing if you have less anxiety. But I think it would be best to avoid cannabis, you no longer respond to it like you used to, our brains change as we get older, antidepressants do more than just increase the amount of serotonin in synapses, they cause subtle and long lasting changes in our neurochemistry (example: the 5HT1A receptor decreases in number when the serotonin levels are up, and thus all the NMDA receptors that interact with the neurons 5HT1A bearing neurons may become more active to compensate for the decreased 5HT1A signaling). You can see how complex the pharmacology of antidepressants are, they do a lot and it may take a lot of time off the antidepressants before things are back to normal. As for the alcohol, I avoid drinking and taking any psychoactive drug, the interactions are unpredictable, except for the complete amnesia the next morning, that always happens.
Votes: +0
MA
MacIntosh12
9 Dec 2012
Hi anonymoususer, here is a partial list of serotonin syndrome symptoms, agitation, heavy perspiring, diarhhea, FEVER, confusion, muscle spasms, overactive reflexes, shivering and tremor. It sounds like what you experienced was not serotonin syndrome. It comes on very fast, and is quite dramatic. Good luck and try to avoid the MJ! Mac
Votes: +0
RO
RonMan
9 Dec 2012
I won't comment on the pot, no experience, but the alcohol is a big no-no with Lexapro. It says so right on the bottle. The warning could not be more clear:
There is 1 alcohol/food/lifestyle interaction with Lexapro (escitalopram):
Lexapro and Alcohol (Ethanol) Moderate Drug Interaction GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
In short stop drinking or limit it to a single glass of wine and even that can be risky.
RonMan
Votes: +1
TE
tejas129
8 Dec 2012
I agree that it's likely not seretonin syndrome. I think it's more likely that you don't smoke much weed, and you likely overdid it that first time you talked about.If you were smoking high grade this can happen without ANY meds,for those who don't partake on a regular basis.Weed elevates the blood pressure,and the more potent it is, the more you will feel the effects.I was on Lexapro and 11 other meds,and smoke every day,in the evening to help me sleep,and it also helps with my apetite.My Psych is completely aware of this and I have his total approval.But I have felt similarly,after smoking a higher grade than I normally do.The rapid heart beat,brings on a sense of panic,and that brings on anxiety.Now, on the alcohol issue,you should not drink at all with Lexapro.Look at your bottle,or the medical report that comes with your script. It says alcohol should NOT be consumed at all.
I have ignored that before, and I black out.That's with both hard liquor and Beer. I can drink 2 glasses of wine and be fine,but we are all different in these areas. My husband who is an occassional smoker,about once every 3-4 months. He can only take 2 hits and sometimes he gets too high and has to go to bed. I'm no Dr, but I know alot about these subjects,and have a different perspective than some. tejas129
Votes: +1
MA
Mars487567
20 Feb 2018
I doubt you have your doctor's "total approval" more likely he knows that confronting you on it is just going to make you dig in more.
IN
Inactive
8 Dec 2012
Hello anonymoususer. No. Not Serotonin Syndrome. A side effect(s) to mixing the Lexapro and alcohol would be opinion. Regards pledge
Votes: +0
IN
Inactive
8 Dec 2012
typo* would be my opinion. Mixing, Cannibis/alcohol/Lexapro
KA
kaismama
8 Dec 2012
Serotonin syndrome is a sudden onset of symptoms, and you would most likely have more symptoms. Most likely what is happening is the interaction of other cns effecting agents with the lexapro. Serotonin syndrome is not as common as people think it is either.
Votes: +1
AN
anonymoususer
8 Dec 2012
Alright, good news! Thank you - I'm a bit of a hypochondriac.
