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

[Guest guest]

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