As a person who seeks to find the healthy, organic, homeopathic route to certain ailments versus using pain medication, I am prone to serotonin withdrawal syndrome. I must fully disclose ALL of my medicinal solutions to my healthcare providers, including supplements, certain massage practices, essential oils, acupuncture, chiropractic remedies, etc., or I am at risk of developing this potentially dangerous syndrome.
Central nervous system medications, such as anti-anxiety medications, antipsychotics, antidepressants, amphetamines and opioids can influence or have effects influenced by the massage. Depending on the type of massage, it may either increase or decrease the effectiveness of these medications.
In fact, when researching some of the symptoms I was experiencing, I found that taking both St John’s Wort and Lyrica concurrently puts me at a high risk of developing serotonin withdrawal syndrome. Furthermore, taking it with my antihistamine Zrytek lowered its effectiveness, putting me at a greater risk of developing chronic sinus infections.
Serotonin toxicity, also known as serotonin syndrome, is a serious, drug-induced medical condition that occurs when there is excessive serotonin in the brain’s synapses. Symptoms of serotonin toxicity can include a combination of the following symptoms:
- Neuromuscular
- Autonomic
- Psychological
Serotonin toxicity is caused by medications that increase serotonin levels in the body. These medications can include antidepressant medications, certain herbal supplements, and even some over-the-counter drugs. When taken together, they can increase the risk of serotonin toxicity. If your reason for over-the-counter solutions is price, speak to your pharmacist about the available low-cost prescriptions your doctor can prescribe.
Serotonin is a vital neurotransmitter in the body, integral in maintaining normal brain and nerve cell functions. It is naturally produced in the body and is necessary for mood, appetite, sleep, and memory.
You must talk to your healthcare provider if you take any medications or supplements that could increase the risk of serotonin toxicity. Your healthcare provider can help ensure that you take the proper doses of medications and supplements to avoid any potential toxicity. Additionally, it is crucial to disclose any changes in medications or supplements to your healthcare team.
Note this article is intended for entertainment purposes only. Always consult a physician or medical professional before taking or implementing any medicinal practices and if you have questions about medication interactions.
What are the symptoms of serotonin syndrome?
Serotonin syndrome is a condition that can happen when you take too much of certain types of medications or start taking a new medicine. For example, it can happen if you mix two medicines that contain serotonin, like a medicine for headaches and depression. It can also happen if you take illegal drugs, special foods, or supplements.
Milder forms of serotonin syndrome may go away within a day or two of stopping the medications that cause symptoms and, sometimes, after taking drugs that block serotonin.
Patients with serotonin toxicity may experience various symptoms, including confusion, restlessness, shivering, increased heart rate, blood pressure, sweating, dilated pupils, muscle rigidity, and even seizures. In more severe cases, it can lead to coma and even death.
Signs and symptoms include:
- Agitation or restlessness
- Insomnia
- Confusion
- Rapid heart rate and high blood pressure
- Dilated pupils
- Loss of muscle coordination or twitching muscles
- High blood pressure
- Muscle rigidity
- Heavy sweating
- Diarrhea
- Headache
- Shivering
- Goosebumps
Drugs that cause serotonin syndrome
The drugs and supplements that could potentially cause serotonin syndrome may include but are not limited to:
- Amitriptyline & Nortriptyline (Pamelor) – Tricyclic Antidepressants – Moderate to Severe Symptoms
- Bupropion (Zyban, Wellbutrin SR, Wellbutrin XL) – Antidepressant & Tobacco-Addiction Medication – Moderate to Severe Symptoms
- Carbamazepine (Tegretol, Carbatrol) – Anti-Migraine Medication – Mild to Moderate Symptoms
- Cocaine – Illicit Drug – Moderate to Severe Symptoms
- Codeine – Opioid Pain Medication – Mild to Moderate Symptoms
- Cymbalta & Drizalma Sprinkle (Duloxetine) – SNRI – Moderate to Severe Symptoms
- Demerol (Meperidine) – Opioid Pain Medication – Mild to Moderate Symptoms
- Desvenlafaxine (Pristiq) – SNRI – Moderate to Severe Symptoms
- Delsym – Over-the-Counter Cough and Cold Medication – Mild to Moderate Symptoms
- Ecstasy – Illicit Drug – Moderate to Severe Symptoms
- Effexor XR (Venlafaxine) – SNRI – Moderate to Severe Symptoms
- Fetzima (Levomilnacipran) – SNRI – Moderate to Severe Symptoms
- Granisetron (Sancuso, Sustol) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Hysingla ER (Hydrocodone) – Opioid Pain Medication – Mild to Moderate Symptoms
- Isocarboxazid (Marplan) – MAOI – Moderate to Severe Symptoms
- Imitrex, Tosymra (Sumatriptan) – Anti-Migraine Medication – Mild to Moderate Symptoms
- Inapsine (Droperidol) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Lithobid (Lithium) – Mood Stabilizer – Moderate to Severe Symptoms
- LSD – Illicit Drug – Moderate to Severe Symptoms
- Marplan (Isocarboxazid) – MAOI – Moderate to Severe Symptoms
- Meperidine (Demerol) – Opioid Pain Medication – Mild to Moderate Symptoms
- Metoclopramide (Reglan) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Nardil (Phenelzine) – MAOI – Moderate to Severe Symptoms
- Norvir (Ritonavir) – Anti-Retroviral Medication – Moderate to Severe Symptoms
- Nutmeg – Herbal Supplement – Mild to Moderate Symptoms
- Oxycontin, Roxicodone (Oxycodone) – Opioid Pain Medication – Mild to Moderate Symptoms
- Pamelor (Amitriptyline & Nortriptyline) – Tricyclic Antidepressant – Moderate to Severe Symptoms
- Paxil, Pexeva, Brisdelle (Paroxetine) – SSRI – Moderate to Severe Symptoms
- Phenelzine (Nardil) – MAOI – Moderate to Severe Symptoms
- Pristiq (Desvenlafaxine) – SNRI – Moderate to Severe Symptoms
- Prozac (Fluoxetine) – SSRI – Moderate to Severe Symptoms
- Reglan (Metoclopramide) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Savella (Milnacipran) – SNRI – Moderate to Severe Symptoms
- St. John’s Wort – Herbal Supplement – Mild to Moderate Symptoms
- Sancuso, Sustol (Granisetron) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Tegretol, Carbatrol (Carbamazepine) – Anti-Migraine Medication – Mild to Moderate Symptoms
- Tramadol (Ultram, ConZip) – Opioid Pain Medication – Mild to Moderate Symptoms
- Valproic Acid – Anti-Migraine Medication – Mild to Moderate Symptoms
- Wellbutrin SR, Wellbutrin XL (Bupropion) – Antidepressant & Tobacco-Addiction Medication – Moderate to Severe Symptoms
- Zofran (Ondansetron) – Anti-Nausea Medication – Mild to Moderate Symptoms
- Zyvox (Linezolid) – Antibiotic – Moderate to Severe Symptoms
- Zyban (Bupropion) – Antidepressant & Tobacco-Addiction Medication – Moderate to Severe Symptoms
- Zoloft (Sertraline) – SSRI – Moderate to Severe Symptoms
Serotonin syndrome risk factors
Serotonin syndrome is a condition caused by taking too much of some types of medicines or supplements. It causes confusion, shivering, fast heart rate, sweating, wide eyes, tight muscles, and in severe cases, coma or death.
Some people are more likely to experience serotonin syndrome than others. For example, you’re at an increased risk of developing serotonin syndrome if you have recently started taking or have upped the dose of a medication that increases serotonin levels, take more than one medication that increases serotonin levels, take herbal supplements that increase serotonin levels, or use an illicit drug that increases serotonin levels.
If you suspect serotonin syndrome, you must talk to your doctor immediately. Your doctor can help you determine the best way to stay safe and healthy.
Although, typically, once serotonin levels are back to their original levels, the syndrome generally doesn’t cause any serious long-term effects that we know of yet. However, we do know that severe serotonin syndrome can lead to unconsciousness and death if left untreated.
Can I take Lexapro and St John Wort?
According to an article by The Mount Sinai Health System (https://www.mountsinai.org/health-library/herb/st-johns-wort), St. John’s wort may interact with medications used to treat depression or other mood disorders, including tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors (MAOIs).
Taking St. John’s wort with these medications increases side effects and could lead to a dangerous condition called serotonin syndrome. DO NOT take St. John’s wort with other antidepressants, including:
- SSRIs: Citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
- Tricyclics: Amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil)
- MAOIs: Phenelzine, (Nardil), tranylcypromine (Parnate)
- Nefazodone (Serzone)
- Allergy drugs (antihistamines)
St. John’s wort may reduce levels of these drugs in the body, making them less effective:
- Loratadine (Claritin)
- Cetirizine (Zyrtec)
- Fexofenadine (Allegra)
- Clopidogrel (Plavix)
- Dextromethorphan (cough medicine)
Theoretically, taking St. John’s wort and clopidogrel may increase the risk of bleeding.
What is serotonin withdrawal syndrome?
Serotonin toxicity is a serious and potentially life-threatening medical condition. Therefore, it is vital to be aware of symptoms and to talk to your healthcare provider if you are taking medications or supplements that could potentially increase the risk of serotonin toxicity. By doing so, you can help to ensure your health and well-being.
Remember, this article is intended for entertainment purposes only. Always consult a physician or medical professional before taking or implementing any medicinal practices and if you have questions about medication interactions.