Serotonin Syndrome

[Heather]

Heather, have you considered dropping the SSRI (Zoloft) and raising the dose of Trazodone?

No, I've never considered that because we're trying to treat the PTSD symptoms and especially right now they're getting worse. I'm lucky I remember my name.

 

[ronin47]

I'm on 200mg of Zoloft and my doctor recently started me on Wellbutrin. In all honesty Heather, I don't think just adjusting your medication is the solution. I began to notice improvements in my memory even before I started taking Zoloft because of the intensive work I was doing in therapy. Consider modifying what you're doing with therapy rather than just modifying your medications. You should also consider regular (at least three times a week) excersice and/or doing some stretching or yoga. That works wonders for helping with sleep. You might even consider sleep aids since there are some fairly benign ones out there such as Benydril that could help a bit. I'm not a psychiatrist, but from what I've heard the others say your nurse is right to be cautious about raising the Trazodone level. And once your sleep improves, it should help your memory as well.

Best of luck to you Heather. I will be sending peacefull, sleepy thoughts your way.

 

[allitherapy]

The pharmacist suggested amitryptaline which is sedating but also has anti-depressant benefits as well. But doesn't effect serotonin levels so that's something to think about when I see her next month.

Amitriptyline can also interfere with Zoloft and some of the other medications you're taking. If you're looking for something to help you sleep, you might consider something like Xanax to be used as needed. I wouldn't recommend that, however, if you have a history of addiction. I take it occassionally and it's really helpful on nights when I just can't fall asleep.

The best thing to do of course is to figure out why you can't sleep and talk about it in therapy. No drug is ever going to fix the problem, and you shouldn't look toward medicine as a solution for your problems. They can help manage symptoms as needed, but the sleep issues should really be worked on in therapy. I know you've said your brain is all over the place lately, and surely that can be from a lack of/too little sleep. Getting enough restful sleep is the best thing you could do for yourself. Drug induced sleep is often not restful sleep because certain drugs don't allow your body to enter all of the sleep stages. I would try really hard to pinpoint what's going on to keep you awake at night and try to come up with some solutions in therapy.

 

[Heather]

Auuuuggghhhh!

That wasn't at you Alli. Just at the situation in general. To much information for one overloaded brain.

Thanks everyone for your input and unending support.:)

 

[allitherapy]

Heather, I know it's hard , but you can do it! Look on the bright side, at least you don't have the sleep problem I had!

 

[anthony]

I'm not sure what APRN exactly stands for, though if it is Advanced Practice Registered Nurse, then I quite honestly would not be taking what a nurse is saying as valid about medication. Even doctors, whilst they do a year on them, the simple fact is, you need to speak with a good pharmacist... these are the experts on medication, and the only people you should ever really turn to when looking for quality solutions based on your history.

You have a doctoral degree taking 4 - 6 years, then a pharmaceutical degree taking 4+ years. A pharmacists does nothing but pharmacy... I would seriously see one vs. trying to nut out solutions specific to you on a forum. I don't know about where you are, but in Australia, you can speak to any pharmacist free of charge by visiting a chemist (drug store I think you call them in the States). I would presume the same is applicable their!

This is the problem with the medical industry... doctors handing out pills left, right and center, but a pharmacist can often give you far better solutions and whether or not a specific pill is best for you, dosage, use, etc. Doctors often follow pharmaceutical companies guidelines, pharmacists often know better, with greater experience, especially when mixing medication.

 

[allitherapy]

I agree with Anthony that the best place to go for information about medications is to a pharmacist. I think the educational component is different in Australia than in the United States. A pharmacist goes to 4 years of graduate school, just like a physician. And yes, you can speak to any pharmacist free of charge, but of course it's best to go to the one who normally handles your medications.
An important point though, is that pharmacists do not have access to your medical history. A pharmacist can tell you everything you need to know about medications, but the reason they can't prescribe it is because they do not know you as a patient. A pharmacist can tell you how wonderful Xanax is, but your doctor won't (or shouldn't) prescribe it if you have a history of substance abuse. So yes, ask your pharmacist the questions, but realize that your physician probably knows what will work best for you, only because they know you as a patient.
A huge problem with the pharmaceutical industry is all of the consumer marketing there is today. Patients see drugs advertised on tv and go into the doctor demanding that particular medicine just because they saw it. A good doctor will prescribe what is best for the individual patient. Contrary to what most people think, doctors now are trained to recognize the evils of pharmaceutical companies and not to prescribe something just because it is the "in" drug at the moment.
I realize I'm rambling, but the point is, if you're going to ask your pharmacist for advice, you need to be an informed patient. You need to know your medical history and be willing to share that entirely with the pharmacist so they can give you accurate information pertinent to your case.
Good luck!

 

[anthony]

Yes, the advertising for US is different, as we do not have such advertising here, as pharmaceutical companies are not allowed to advertise such drugs across any medium here, tv, radio, newspapers, billboards, etc... as they are prescription only items. Guess that increases issues for those in the US vs. other countries.

Even non-pharmaceuticals, very strict laws on advertising here, ie. Berocca just got bounced right out of all advertising, as scientific testing determined it provides zero energetic (bounce) to your daily life, as they have advertised previously, therefor it was deemed false advertising and all pulled. Nicotine also cannot be advertised here, and actually now reside behind hidden fronts even in shops, so they are not seen... zero advertising of them allowed.

 

[anthony]

Oh... yes, pharmacists here also cannot prescribe... but they can see your entire pharmaceutical history, as they are the one's who control that aspect. As Alli stated, which I maybe did not clarify well, between them, get the expert consensus on each aspect from each relevant expert.

 

[Heather]

Nicotine also cannot be advertised here, and actually now reside behind hidden fronts even in shops, so they are not seen... zero advertising of them allowed.

The United States could learn a thing or two from Australia. How come we don't do that here?

 

[Grace11]

APRN = Advanced Practice Registered Nurse, that is correct. It varies so much for many. In my experience, the APRNs have been more thorough than the doctors, actually. The difference in the advanced degree is that they can prescribe meds. Definitely follow your instincts here as well as getting another opinion. I prefer the APRNs at most of the facilities I have visited, but it is based on personal experience.

I am on an SSRI that I am gradually weaning from due to the cost of the medication. I haven't been on 2 at the same time....make sure you keep track of how you feel during different times of the day and remember that a lot of these meds aren't effective in the beginning. I was a bit zombie-ish and sleepy with mine in the beginning, which wore off, but if I hadn't known that, I would've stopped taking it after a week or so, which wouldn't have benefited me long term...

 

[anthony]

A nurse can prescribe medication? Seriously! :eek: No disrespect to APRN's, but I can only see bad things coming from medication being prescribed outside of doctors. Doesn't the US have enough issues without adding more to the pharmaceutical industry?

Shocked a little...