Serotonin Syndrome, Duloxetine / Mitrazapine?

[halandpeeno]

I have just emerged from the most hellish 3 weeks of my life. I have been prescribed Sertraline for depression (was on it 5 years ago. 200mg seemed to help but found titrating up v. hard).

Started on 50 mg for about a week, increased to 100mg, all hell broke lose.
Woke up in the morning with such a severe headache I vomited. I couldn't stand up, was sensitive to light, having multiple panic attacks on top of each other, twitching muscles and sweats. I couldn't talk without retching or panicking. I basically stayed in a ball on the bed for 3 days. It would ease off slightly in the evenings to the point where I could speak but returned by the morning. I stupidly persisted with taking the 100mg every morning for the next 3 days as i thought I had to just go through it to come out the other end. It was hellish, like I was trapped on a galloping horse and I honestly thought I may have to kill myself which terrified me.
After 3 days I tried t get a GP appointment but was passed to A and E. I was in A and E for 15 hours (nobody had any beds and there were people lying on the floor). They wanted to admit me (CAT scan was clear) but said it would be another 15-20 hours in the waiting room. They gave me IV fluids, oramorph and IV Metolclopramide which basically made me so agitated I discharged myself.
A follow up with a consultant (after my notes were lost) have said they suspected Serotonin Syndrome which possibly triggered migraines.
I am now on no medication, they have suggested Duloxetine or Mitrazapine. I cannot however get any continuity of care from my GP (CQC rated failing, 4 hour wait on the phone, no face to face appointments) I am too scared to start anything again but I don't know where I can turn for help if things go bad again. I am still nauseous all the time and quite frankly traumatised by the whole thing. I am too scared to start medication and too scared not to?
Has anyone had a similar experience with SSRI or Serotonin Syndrome? Which of the two antidepressants has anyone had experience with?

It was for depression. I haven't been right for a while, I spent 16 years working in a job where I witnessed a lot of trauma and it haunts me. I am having talking therapy but I am just permanently miserable. It's not fair in my husband or kids.
I have now been off everything for 2 weeks. I still cannot sleep (regularly awake until 5am) which also impacts on my mental health. I have been on Amytryptyline previously which helped with sleep but I stopped as I was getting a dry mouth.
It was a big step for me to consider going back on SSRI and I had the tablets for at least 2 months before getting the courage to take them.
I've had 2 locums tell me just to give it a go again but who is going to help me if something like this happens again?

Don't just give a go! serotonin syndrome can kill and quickly. It's dangerous.
I had this after a single dose of Sertraline. It was hell on Earth and I thought I was going to die.

It's on my notes and not my GP or the psychiatrist would prescribe me SSRI or SNRI now for this reason. Too risky.

Psychiatrist thinks avoiding meds and doing it with therapy is the way to go.

The other thing is. If you suffered serotonin syndrome from a couple of doses, you don't have low serotonin as a cause for depression! You don't need to add any more serotonin as you already have plenty.

Unless you were taking meds which interact with SSRI?

I'm surprised A&E gave you morphine. Tramadol, morphine and codeine increase serotonin levels. Anyway. They wouldn't give me any as they though it would finish me off when it happened to me. Very frightening experience.

Took several weeks to feel fully better. Am definitely cured of thinning medication is the easy answer.

dane8.
My sister mentioned it could be menopause - as I am 43 it could definitely be on the cards. I mentioned it to a locum and they said 'yes it could be' and that was the end of that.

The amytryptyline I took was for chronic pain, then they switched me to Pregablin which I slowly stopped taking over 6 weeks. It was a horrible drug that I didn't want to be on in the first place. So I am now not taking anything and barely sleeping.

I still feel completely foggy and shaky from everything that has happened. Like I don't really know myself anymore. I have even considered trying to see a private Psychiatrist as the though if another random GP throwing me some tablets without any support terrifies me. In the middle of it last time it took my husband 2 days to get through to the surgery and was then told they couldn't help. He then spent 8 hours and got cut off over 15 times by 111. I don't know where to get support, guidance or advice when taking these kind of medications and am extremely wary of something similar happening again

Just a warning to be careful with any migraine medication and SSRI ADs, as there are known side-effects similar to your experience. Wishing you well, what an awful experience for you. X

dane8 Many thanks they are all good ideas that I will follow up on.
I have contacted the doctor again. They said it will take a week before they can even triage me. After triage they give you a day where they call anytime between 9-6. Or, like in the past they don't call at all and you have to chase reception, waiting time on the phone averages over an hour with you randomly getting cut off and having to start the process again. It's no wonder the CQC said they are 'a risk to patients'. Unfortunately the nearest six surgeries are all part of the same group.
I just feel utterly defeated at the moment, my youngest is ill and home from nursery so I am trying to look after him while working from home simultaneously.
I am lucky I have a supportive husband and am aware that many people have no one.

Hi sorry I know this is an old post but I have just been going through this as well and I wondered how you were getting on OP. Did you try taking anything again or not?

My combination is Fluoxetine for depression and Co-codomol for pain. I was OK with this combination but recently had not had it as regularly and took the full dose together (40mg fluoxetine and 2 X 30/100 co-codomol)

I have felt terrible, not ended up in A&E but can see how that could happen.

Heart racing, very breathless, nauseous, shaky, faint, now it is a bit better but still there.

I'm wondering about re-introducing it more gradually as generally OK in the past when I built up the dose more.

Online it says it can be worse if it is a sudden increase. I feel quite scared and apprehensive about taking these but also feel I need them to deal with my conditions.

Anyway whatever happened I hope you are doing OK now OP. The hospital visit sounds traumatic. Please come back and say how you are doing if it helps you. Best wishes