Serotonin syndrome: much more awareness needed

Some days ago I was prescribed Sertraline 50mg. Just being accepted by my GP and getting some reassurance made me feel vastly better, but also very emotional. I was fairly low due to continuous poor sleep, which I don't handle well.

The talk with my doctor made me feel so much better, that I was reluctant to start the Sertraline. But I was just a bit concerned that my much better state might have been temporary, so I decided to take the first dose. I was somewhat apprehensive about dry mouth and insomnia, less so about nausea.

I took the tablet at about 10pm. By the early hours (I had awoken as usual), I had a slightly overactive gut with lots of wind, but was pleasantly surprised that I felt fine otherwise. 

I woke later in the night to absolute hell. I woke with a tremendous start, with an indescribable feeling of terror, extremely agitated, and heart racing. This settled after a while, to be followed by intense nausea, sweating and the urge to open my bowels. I managed to reach the loo, but was extremely dizzy, stumbling and falling into things. Diarrhoea was followed by an episode of extreme sweating from my icy-feeling forehead (sweat hitting the floor like a shower of rain).

I rested for the day and physically was left with weak legs, very dry mouth and excessive sweating.

Far worse, I was left with intense feelings of anxiety, far worse than anything i had previously. I woke to a panic attack 48 hours after the dose. I am feeling somewhat calmer today

I took just the one tablet. I take no other medication whatsoever.

Researching my reaction after the event, I now know that I suffered Serotonin Syndrome (or Serotonin Toxicity). I dread to think what might have happened has I taken the tablet at breakfast time and maybe been out somewhere when this happened.

All of the symptoms I experienced, taken individually, or even a couple together, might be considered "normal", but the occurrence of all together in this fashion, is Serotonin toxicity, of which there seems to be far too little awareness. (The NHS website entry is not especially useful here, because it failsto stress that it is the number and nature of symptoms occurring together which seems to be the key issue).

https://patient.info/doctor/serotonin-syndrome

Those who experience the syndrome are not helped by well-meaning forum contributors who urge perseverance with the medication.

Emis Moderator comment: I have replaced the given link with a link to the equivalent article on our site.

Also, while this may be your experience it does not mean it will happen with all patients.

Gosh that sounds awful , hope you are on the mend , good luck

Sorry to hear you've had such a reaction, but I doubt if you had suffered serotonin syndrome somehow. Please do read the patient info leaflet that came with your meds to find out about side effects. Or google search them. It's known among us that antidepressants can make you worse before better, and startup effects can be quite frightening. I'd chat again with your doc or pharmacist. Good luck

I think you and sertraline do not mix too well. Serotonin syndrome is due to an overdose of serotonin, unless you are already stuffed with serotonin, which I doubt. All the best 😀