Can taking temazepam 7.5mg 1 time a day and 60mg fluoxetine 1 time a day, and propranolol 10 mg 1 time a day 4-6 hours between the temazepam. And loprazam 7.5 mlg as needed. Can taking all 4 of these daily cause serotonin syndrome?
Serotonin syndrome - can taking all these medications cause it? What’s the likelyhood?
Question posted by Ladybex on 22 April 2025
Last updated on 23 April 2025 (4 weeks ago) by Eupelia
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3 Answers
Eupelia
23 April 2025
The symptoms of serotonin syndrome can happen just from bad generic drugs and you really have to be careful and add drugs individually because it can be a manufacturer with really poor quality pills there was just a study in February from Ohio State talking about how dangerous generic drugs from outside the country are
Alphabravo33
22 April 2025
Serotonin Syndrome is unlikely based on the combination of those 4 medications. However as others have said, it’s always a good idea to mention your concerns to your prescriber or your pharmacist.
masso
23 April 2025
Fluoxetine:
"Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea."
Source: https://www.drugs.com/fluoxetine.html
Nothing else to add, masso
masso
23 April 2025
Causes
SS most often occurs when two or more medicines or drugs that affect the body's level of serotonin are taken together at the same time. The medicines cause too much serotonin to be released or to remain in the brain area.
For example, you can develop this syndrome if you take migraine medicines called triptans together with antidepressants called selective serotonin reuptake inhibitors (SSRIs), or selective serotonin/norepinephrine reuptake inhibitors (SSNRIs).
Common SSRIs include:
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
SSNRIs include:
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Levomilnacipran (Fetzima)
Milnacipran (Savella)
Venlafaxine (Effexor)
Common triptans include:
Almotriptan (Axert)
Eletriptan (Relpax)
Frovatriptan (Frova)
Naratriptan (Amerge)
Rizatriptan (Maxalt)
Sumatriptan (Imitrex)
Zolmitriptan (Zomig)
If you take these medicines, be sure to read the warning on the packaging. It tells you about the potential risk of SS. However, do not stop taking your medicine. Talk to your health care provider about your concerns first.
SS is more likely to occur when you first start taking or increase the dose of the medicine..
Older antidepressants called monoamine oxidase inhibitors (MAOIs) can also cause SS when combined with the medicines described above, as well as meperidine (Demerol, a painkiller), fentanyl, dextromethorphan (cough medicine), and others.
Street drugs, such as methamphetamine or other amphetamines, cocaine, opiates, ecstasy, LSD, and others have also been associated with SS.
Source. National Library of Medicine
In the United States, 7 triptans are available in diverse dosage formulations, including sumatriptan, naratriptan, zolmitriptan, rizatriptan, almotriptan, frovatriptan, and eletriptan. Sumatriptan, in its subcutaneous formulation, is also approved for treating cluster headaches.
Source: National Library of Medicine
What are Monoamine oxidase inhibitors?
Monoamine oxidase inhibitors (also called MAO inhibitors or MAOIs) block the actions of monoamine oxidase enzymes.
Source and detailed info: https://www.drugs.com/drug-class/monoamine-oxidase-inhibitors.html
WildcatVet
22 April 2025
Hi Ladybex! There isn't any problem taking all four medications because your two tranquilizers and the propranolol... a cardiac drug used to control the symptoms of anxiety... shouldn't affect serotonin levels.
Fluoxetine though can potentially raise serotonin levels although this is rare. This link will answer most of your questions about the syndrome:
https://www.drugs.com/cg/serotonin-syndrome.html
If you still have concerns it's best to talk with your doctor or pharmacist.
Best regards, Wildcat
Related topics
fluoxetine, propranolol, temazepam, anxiety and stress, medication, syndrome
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