Re: Serotonin syndrome and information about some prozac(fluoxetine)/supplement interactions,,,,,, fyi for those on the CM protocol

[Guest guest]



I am on Zoloft ...I knew about the syndrome.. but my information warned against some meds.. one of them being Guafsin ( expectorant). But it did not say WHY. Oddly.. I just got over a cold and the asked the pharmacist if I could take it. She Poo Pooed it and said it was fine...I dunno..but mentioned Dextro.. that I should avoid that.

Steph

[DownSyndromeInfoExchange] Serotonin syndrome and information about some prozac(fluoxetine)/supplement interactions,,,,,, fyi for those on the CM protocol

Maybe you all already know this, but it was all new to me, so ..just in case….

I was reading an article about serotonin today, and came across this information:

http://www.peoplespharmacy.com/archives/editorial/serotonin_syndrome_can_be_deadly.asp

“Many people take antidepressants like Zoloft, Paxil or Prozac. Serotonin syndrome may be rare, but the danger is so severe that everyone taking an SSRI antidepressant should be warned about potential interactions with migraine medicines like Imitrex or Maxalt, the pain reliever Demerol, the diet pill Meridia, the OTC cough remedy dextromethorphan, the "club drug" ecstasy or even the herb St. 's wort. All increase serotonin. Combining such drugs could be flirting with death.†End quote

http://www.streetdrugs.org/dxm.htm

Dextromethorphan (DXM)

DXM is a cough-suppressing ingredient in a variety of over-the-counter cold and cough medications. Dextromethorphan, a semisynthetic narcotic, is an ingredient found in any cold medicine with "DM" or "Tuss" in the title or name. There are approximately 70 different products on the market that contain DXM.

Here is an explanation of ‘serotonin syndromeâ€:

http://en.wikipedia.org/wiki/Serotonin_syndrome

Prozac …………Interactions with Supplements

http://health.med.umich.edu/body.cfm?xyzpdqabc=0 & id=6 & action=detail & AEProductID=hw_cam & AEArticleID=hn-1385001 & AEArticleType=Cam

Folic acid

Low blood levels of folic acid have been correlated to poor response to fluoxetine.1 Furthermore, the addition of folic acid to fluoxetine appears to enhance the effectiveness of the drug. A double-blind trial found that depressed women receiving 500 mcg of folic acid per day in addition to fluoxetine experienced significant improvement in their symptoms, as well as fewer side effects, compared with women receiving only fluoxetine.2 Similar results were not observed in men; however, men appear to have a higher requirement for folic acid than do women, so a higher intake may be necessary.

Melatonin

Administration of fluoxetine for six weeks significantly lowered melatonin levels in people with seasonal affective disorder (SAD) and in healthy persons as well.3 Further study is needed to determine if this might interfere with sleeping or whether melatonin supplementation might be appropriate.

L-tryptophan

L-tryptophan is an amino acid found in protein-rich foods. Foods rich in L-tryptophan are not believed to cause any problems during fluoxetine use. However, dietary supplements of L-tryptophan taken during fluoxetine treatment have been reported to cause headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.4

My note: Nutrivene D contains L-tryptophan : http://www.altonweb.com/cs/downsyndrome/ntdrda.html

5-Hydroxytryptophan (5-HTP)

Fluoxetine works by increasing serotonin activity in the brain. 5-HTP is converted to serotonin in the brain, and taking it with fluoxetine may increase fluoxetine-induced side effects. Until more is known, 5-HTP should not be taken with any SSRI drug, including fluoxetine.

DHEA

DHEA supplementation (50 mg per day) has been shown to restore the response of beta-endorphin, a brain chemical involved in pain and pleasure sensations, to fluoxetine.5 Further research is needed to determine if this drug combination is safe for long-term use.

Interactions with Herbs

Ginkgo biloba

Ginkgo biloba extract (GBE) may reduce the side effects experienced by some persons taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly, depressed persons found that 200-240 mg of GBE daily was effective in alleviating sexual side effects in both men and women taking SSRIs.6 One case study reported that 180-240 mg of GBE daily reduced genital anesthesia and sexual side effects secondary to fluoxetine use in a 37-year-old woman.7

St. 's wort (Hypericum perforatum)

There have been no published reports about negative consequences of combining St. 's wort and fluoxetine. One case has been reported of an interaction between St. 's wort and a weak serotonin reuptake inhibitor drug known as trazodone that is vaguely similar to fluoxetine.8 In another case, a patient experienced grogginess, lethargy, nausea, weakness, and fatigue after taking one dose of paroxetine (Paxil®, another SSRI drug) after ten days of St. 's wort use.9 Nevertheless, some doctors are concerned about the possibility of an interaction between St. 's wort and fluoxetine causing side effects (e.g., mental confusion, muscle twitching, sweating, flushing) known collectively as serotonin syndrome.10, 11 Until more is known about interactions and adverse actions, people taking any SSRI drugs, including fluoxetine, should avoid St. 's wort, unless they are being closely monitored by a doctor.

Other Interactions

Food

Fluoxetine may be taken with or without food.12