Another bout of serotonin syndrome

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Date Joined Oct 2009
Total Posts : 4970
   Posted 10/27/2010 10:21 AM (GMT -6)   
I took an extended release tramadol yesterday morning, then an additional instant release later because of much worse than usual pain.  I've taken two instant release before for breakthrough pain with no problem.  But this time, about the time the instant release was wearing off (usually good for 4 hours), I found myself red in the face and getting terrible pain in the bones underneath.  It was the beginning of serotonin syndrome, which I've had before from mixing tramadol with Flexeril.  I took a diazepam, which I did before with good results.  This time it didn't get rid of the pain and flushing, and   this morning it's still here, but not worse!  (Last time I didn't recognize the problem until my whole body was red and sweating.)
I had been off tramadol while in the hospital for a bad bout of diverticulitis, since I didn't want to mix pain meds and needed something much stronger.  Since restarting with just the instant release I have noticed a few muscle spasms in the thighs - clonus.  Since instant release doesn't last the night I had restarted the extended at night.  Yesterday I thought I could restart the extended in the morning.  It doesn't work very fast or well at first, but it does last.  Mistake!
So today I took another diazepam, just took Tylenol, and got an appointment with the pain doc for Monday.  I had already talked with my PCP who knows something about serotonin. I guess it's time for something new for pain.  Tramadol was taking care of the fibro muscle pain, but it isn't enough for the worsening back pain.  I can't take vicodin until the serotonin calms down either, because it's on the list for interacting with whatever's left of the tramadol. 
Just another anecdote about serotonin.

Mrs. Dani
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Date Joined Jun 2009
Total Posts : 2787
   Posted 10/27/2010 10:33 AM (GMT -6)   




TWO roads diverged in a yellow wood
And sorry I could not travel both
And be one traveler, long I stood

Chronic Pain Moderator

Veteran Member

Date Joined Oct 2009
Total Posts : 4970
   Posted 10/27/2010 1:44 PM (GMT -6)   
Thanks. I do know the symptoms. I hope others will read and learn them too. If let go seratonin syndrome can be life-threatening. If I weren't in contact with my PCP I would have been to the ER. They would have given me the same treatment, although probably IV.

Today I'm struggling with no pain med, since I can't get in to pain doc until Monday.

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 10/28/2010 4:53 AM (GMT -6)   
I'm sorry about your experience Alcie. I have had SS a couple of times myself and I DON'T like it at all!!!

Very interesting article Dani!

I did not know about a couple of them. I have never had a problem with the pain meds part, but the migraine meds and any ssri's or snri's are a real problem. So were the OTC's that have DM or DX on them. I just had no idea it could be those causing the problem.

I do have depression and they have tried several anti-depressants, but the last one landed me in an ambulance from work to the hospital. You would think they realized what they were doing when I had the same reactions to the migraine meds. My psych is the one who told me about the link ther and to never, never take or allow migraine meds again!

Great information!
Retired Mom

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Date Joined Sep 2009
Total Posts : 663
   Posted 10/28/2010 5:10 AM (GMT -6)   
Wow, scary stuff! I hope you are feeling better Alcie. Take care.
Gentle Hugs,

Fibromyalgia, Chronic daily headaches, Migraines, Possible Graves Disease, GERD, High blood pressure, Depression and Anxiety

Oxycontin, Lopressor, Lexapro, Omeprazole, Promethazine as needed for nausea, Ventolin inhaler and Vitamin D3
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