Serotonin Syndrome

  Рет қаралды 34,564

Strong Medicine

Strong Medicine

2 жыл бұрын

A review of the clinical presentation, etiologies, differential diagnosis, and treatment of serotonin syndrome.
A part of Strong Medicine's series on Underappreciated Diseases.
#MedEd #Toxicology #SSRI

Пікірлер: 56
@term531
@term531 7 ай бұрын
September 18, 2022 is my second birthday. My symptoms lasted for 20 hours, I passed out countless times, I was shaking UNCONTROLLABLE, I had diarrhea, my heart wanted to jump out, but at the same time I couldn't stand on my feet. When I was conscious I prayed to God to forgive my sins if this is the time for me to leave. After everything, they told me in the emergency room that it was a panic attack, countless infusions, because I was in two hospitals. I knew it wasn't because I was passing out all day. I was on anti-depressants and migraine medication, both of which have high doses of serotonin. I thank God for a second chance, and I am afraid of the incompetence of our doctors. 18.09. is the date of my patron saint and I know who saved my life then. Since then, I've been fighting and struggling with panic attacks, but that day was not one of them.
@aaliyanworld7775
@aaliyanworld7775 5 ай бұрын
Bro what was the cause of you getting this syndrome?
@tatianatub
@tatianatub 2 жыл бұрын
as someone who is on SSRI's and amphetamines i am highly appreciative of serotonin syndrome and am always very careful when taking drugs
@kyleocallaghan9185
@kyleocallaghan9185 2 жыл бұрын
Really do enjoy your material - thank you so much again for taking the time to do these.
@roseennin1149
@roseennin1149 2 жыл бұрын
really appreciate the new content Dr.Strong, God bless you for sharing your knowledge with other up and coming Drs. in the medical community
@yehtetaung9072
@yehtetaung9072 2 жыл бұрын
Grear job Eric, Really enjoy your video presentations.
@ConanLiuMD
@ConanLiuMD 2 жыл бұрын
Learned all about serotonin syndrome in medical school but until you see it the first time and have it in the back of your mind, it can be hard to recognize! We recently had a cancer patient who was on citalopram, trazodone, olanzapine, and recently started on duloxetine for neuropathic pain who ended up coming in with altered mental status. Our attending noticed her hyperreflexia which kind of clinched the diagnosis. I don't typically check reflexes all that often so I definitely learned that I should add that to my repertoire. Also regarding the EMR notifications - I totally agree that they can become so burdensome and the default is to ignore them 99% of the time. They really are important though and hopefully the EMR can continue to be improved so they become more useful rather than just bloat. That part where you discussed all the potential medication complications that can occur if we aren't careful . . . it just made me realize how scary it can be with how much potential harm we can do to patients if we aren't careful with even just a simple new medication prescription.
@ProgressiveTruthSeekers
@ProgressiveTruthSeekers 2 жыл бұрын
Can you get chills and sleepiness, without a fever? I took 5-HTP the night before.
@helenalovelock1030
@helenalovelock1030 Жыл бұрын
My 21 year old daughter was prescribed 20mg of Citalopram for ongoing bad anxiety. She got serotonin syndrome within 48 hours. Was this too high a dose to start with or just something that will not work for her? Does she possibly have very high natural serotonin levels and then the Citalopram made it worse? She’s losing hope that anything can help with the anxiety now which is affecting her daily life.
@SKARTHIKSELVAN
@SKARTHIKSELVAN 2 жыл бұрын
Thanks for your efforts in making these videos.
@rafatmohammed9680
@rafatmohammed9680 2 жыл бұрын
Thank you very much for this excellent explanation
@cheetahgoldenfire
@cheetahgoldenfire Жыл бұрын
Thank you for this very informative video.
@sturmfreii7219
@sturmfreii7219 Жыл бұрын
Thank you so much for the thorough video. I am recovering from this rn and it was scarier than breaking any bone or having covid.
@VyewVyew
@VyewVyew 2 жыл бұрын
Another excellent video
@khalidbashir7435
@khalidbashir7435 2 жыл бұрын
Great job Dr strong
@magdalenagroover
@magdalenagroover Жыл бұрын
What a video!!!!!! Thank you, thank you, thank you.
@tasneemA.haroun93
@tasneemA.haroun93 2 жыл бұрын
Thanks a million ❤. Salute !
@Anna_kandy
@Anna_kandy Жыл бұрын
I experienced this after taking a cough and cold otc syrup. I was freaking out. It was 7 years ago. Never did again. I was a med student then and read my ass off to come up with Serotonin syndrome, and realized a lot of doctors weren't aware of it.
@thomasthompson1846
@thomasthompson1846 2 жыл бұрын
I found this very useful information thank you
@elgilany11
@elgilany11 2 жыл бұрын
Great as usual, would like a video on NMS
@sunving
@sunving 2 жыл бұрын
Thank you very Much Dr Strong. I think the first case came to flame is from combination of Prozac and Meperidine( Pethidine) morphine derivative pain killer. I am not sure wether they are still in used but it was used widely in my time for post operative pain killer. Actually SSRI and Morphine is not a problem? Selective Monoamine oxidase inhibitor are widely use in Parkinson’s. Dextromethorphan with SSRI or other serotonergic drug drug interaction are common but not fatal to make a news. Patient can feel mild agitated or high or headache like. Patient who is on Welbutrin ( Buproion) and Dextromethorphan could double the dose of Dextromethorphan. The mild case of these phenomena happened often but the fatal case is not thank god.
@cassiejosephson6644
@cassiejosephson6644 Жыл бұрын
I was one of the rare cases needing mechanical ventilation. I was on the vent for 9 days and even coded once. My serotonin syndrome went undiagnosed for a couple years until I lost the ability to move, speak and open my eyes. Then I became very rigid and had upper, lower and ocular clonus and lost consciousness.
@zandarzandarevic5466
@zandarzandarevic5466 Жыл бұрын
I hope you are better now..
@muhammadismail3385
@muhammadismail3385 2 жыл бұрын
Sir your videos are too brilliant .... love your work, always wait for your next video. how can I get a ppt/pdf of your excellent work? many thanks sir
@mmeIodie
@mmeIodie 2 жыл бұрын
I experienced it when i was in a very low point in life and took almost 30 antidepressants it was very close to me damaging my kidneys and or liver
@drew14491
@drew14491 2 жыл бұрын
Grazie.
@ProgressiveTruthSeekers
@ProgressiveTruthSeekers 2 жыл бұрын
Can you get chills and sleepiness, without a fever? I took 5-HTP the night before.
@TaraTheFox
@TaraTheFox 4 ай бұрын
Someone gave me sertraline, trazodone, and a 5HTP supplement to start all at once. I didn't get the full syndrome but I had a bad couple days. Thanks for covering this topic.
@marekfutryna3804
@marekfutryna3804 2 жыл бұрын
If you added subtitles i would be very grateful !
@marisapaola9010
@marisapaola9010 2 жыл бұрын
I had this for five years. My GP gave me Effexor and tramadol, I thought I was going mad, saw many specialists, wasn't until I went to a new chemist who looked me over and told me he wasn't going to sell me these in combination. Went to my gp and she was bvwet flippent. Left me with severe tachycardia and heart failure. Edit note.. thankyou for this post & no unfortunately, progressive heart failure, uncontrolled hypertension, and progressive tachycardia, kidney damage, COPD, acidocis. I am in my early forties and lived a very clean life.
@StrongMed
@StrongMed 2 жыл бұрын
I'm so sorry to hear what you went through, but thank you for bringing this up. On uncommon occasions, serotonin syndrome can persist for a long time before diagnosis if the presentation is *relatively* mild (relative to the more "classic", acutely life-threatening presentations), particularly if autonomic dysfunction (e.g. tachycardia) and anxiety are the predominant symptoms. Patients and their physicians can mistake the symptoms as manifestations of primary psychiatric disease (which ironically was often the reason for prescribing the causative meds in the first place!). I hope you are doing better now.
@brendanhoffmann8402
@brendanhoffmann8402 2 жыл бұрын
I suspect I might have this, I'm on 80mg Prozac, 4mg Risperidone. I was on valproate for 10 years up until september last year too... I can't sit still, can't sleep, sweating constantly... they put me on 20mg of propranolol 3 times a day it it hardly does anything. I also get bad gastro-intestinal problems. I was diagnosed with OCD and drug induced psychosis for all this...
@dr.ridwan7157
@dr.ridwan7157 2 жыл бұрын
Very great
@scirun9135
@scirun9135 2 жыл бұрын
Thank you
@judypeng4748
@judypeng4748 2 жыл бұрын
Every day come here to get little more knowledge😁
@fightingalefight
@fightingalefight 2 жыл бұрын
Thankyou
@storyshiftchara1291
@storyshiftchara1291 2 ай бұрын
If you feel floaty is that a sign of serotonin syndrome?
@dailydoseofmedicinee
@dailydoseofmedicinee 2 жыл бұрын
👏👏
@shovelhead4558
@shovelhead4558 Жыл бұрын
O dear I was in A&E yesterday lost a lot of weight, breathing bad, sight much worse, uncontrollable limbs tremors,muscle wastage blood in stools,blood pressure up and down, sweats bad,headaches from hell red raw throat pins and needles arm’s legs muscles constantly moving stressed they get worse confusion memory’s not there ,my tablet’s are Sertraline 100mg,Fluvoxamine 50 mg,Allopurinol 100mg,irbesartan 75 mg,Atorvastatin 40mg,Melatonin 4mg at night,Clopidogrel 75mg,they told me to go home it was drug withdrawal I feel like I am slowly dying no strength can’t figure out anything even a measuring tape live in Jersey Channel Islands U.K. I know 4 of the meds above raise Sertraline hell i am desperate.
@Dan-by2vj
@Dan-by2vj 2 жыл бұрын
wow, this guy looks like Chris Parnell.thanks Dr. Spaceman
@StrongMed
@StrongMed 2 жыл бұрын
I usually hear either Parnell or Alan Ruck (Cameron from Ferris Bueller's Day Off, among many other things)
@kermitthehermit9588
@kermitthehermit9588 6 ай бұрын
@@StrongMed for a second I thought you WERE Alan Ruck
@vadimuha
@vadimuha 2 жыл бұрын
So that's why I have dilated pupils and agitation from time to time on AD's
@Layingflat
@Layingflat 6 ай бұрын
Duloxetine did it to me. I lost a kidney, lucky not to of lost my life.
@twistedtea7046
@twistedtea7046 2 жыл бұрын
also known as psych NP syndrome
@lexaproishere
@lexaproishere 2 жыл бұрын
Would there be any reason why I keep giving myself serotonin syndrome on purpose?
@MtCoronet0
@MtCoronet0 2 жыл бұрын
What the Fuck.
@TheyWillKnowAnother
@TheyWillKnowAnother 2 ай бұрын
Stop being edgy
@dalmar199
@dalmar199 2 жыл бұрын
Fatal syndrome
@SisterMorphine
@SisterMorphine 9 ай бұрын
rigid deltoids haha😄
@tinyguy9398
@tinyguy9398 2 жыл бұрын
One thing I wish my doctor or pharmacist could answer is whether I can take my Pantoprazole (PPI) with my Fluvoxamine (Luvox: SSRI). Being that I’m on a lot of medications for an autoimmune disorder I always check for medication interactions on WebMD when I’m put on a new medication. I was recently put on Fluvoxamine for chronic depression and anxiety brought on by acute stress brought on by my ruminating OCD. It had absolutely no interactions with any other medications I’m taking except for the PPI. Apparently Fluvoxamine can mess with the metabolism of Pantoprazole causing it to amplify the dosage received; so in effect, a 40 mg dose can potentially have the same potency as if I’d taken a 120 mg dose. It greatly bothers me that no one can answer this question as I take the Pantoprazole for chronic GERD and relying on Tums for the past few months to keep my stomach acid in check is just not working. Is there any literature on just how common or uncommon the risk of a severe reaction between Fluvoxamine and Pantoprazole has of occurring? Google seems to have mixed data on this at best and my pharmacist says they don’t see the interaction listed in their system even though I can clearly see it in WebMD’s database. Obviously this is not related to Serotonin Syndrome but can’t hurt to ask.
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