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This question was answered on Wed 30, Jul 2008 01:28am by Dr Bhupinder, MD
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Serotonin Syndrome from Nortriptyline or depression?






    
Asked by Unregistered (Female; 19; Cronic migraines; Relevant drugs:nortriptyline ) on Wed 16, Jul 2008 10:50am :

When I was 11 I was prescribed nortriptyline for migraines. I took 3 10 mg every night before bed. Sometimes I would forget so I would take like 6 to 8. I stayed on my meds for 5 years. When I was 14 I started cutting myself. One day I decided myself I didnt need it anymore because I wasnt getting migraines. I just recently discover that nortriptyline is an anti-depressant. Now I wonder if the reason I cut myself is because I was on nortriptyline. I get twitchs sometimes throughout the day. I stare off a lot. I have really good friends but I have no intrest meeting new people. My question for you is, is it possible that I have Serotonin Syndrome? Please help I dont know what I should do.

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Answer by Dr Bhupinder, MD (doctor) on Wed 30, Jul 2008 01:28am:

Hi, this is not serotonin syndrome as this syndrome is caused by over dosage of medicine or when one is taking 2 or more antidepressants of same class simultaneously. But you have already stopped the medicine. In case of serotonin syndrome “Symptom onset is usually rapid, often occurring within minutes after self-poisoning or a change in medication. Serotonin syndrome encompasses a wide range of clinical findings. Mild symptoms may only consist of tachycardia, and shivering, diaphoresis (sweating commonly associated with shock), mydriasis (dilated pupils), myoclonus (intermittent tremor or twitching), as well as overactive or overresponsive reflexes. In addition moderate intoxication includes abnormalities such as hyperactive bowel sounds, hypertension and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication. The overactive reflexes and clonus in moderate cases may be greater in the lower limbs than in the upper limbs. Mental status changes include hypervigilance and agitation. Severe symptoms include severe hypertension and tachycardia that may lead to shock. Severe case often have agitated delirium as well as muscular rigidity and high muscular tension. Temperature may rise to above 41.1 °C (105.98 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation”. Taken from website http://en.wikipedia.org/wiki/Serotonin_syndrome Please consult doctor as this might be withdrawal effects of drug and please get drug optimization done.
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