Serotonin

About a year ago I was diagnosed with serotonin syndrome, however it was irregular in which only one drug would cause the effects. I have been very carful to avoid drugs that will increase my serotonin for it will result in; heavy sleeping (sleeping 24 hours for up to four days), extreeme stuttering, confusion, and deep depressive episodes (when the drug first takes affect, I will cry and scream about how everyone is mad at me for my stuttering and how everyone thinks I'm faking or other such things). In one severe case I even suffered double vision for about six months. I have been hospitalized for an extended ammount of time twice for this reaction.

Recently, the side affects came on once more only without the aid of a drug. I was normal one minute and stuttering the next. Could this be purely psychological or could there be another reason for my reaction (perhaps a serotonin imbalance?) and is there anything I can do. Thank you for your help.

F.Kiss - I am not sure what you were told, but serotonin syndrome is not a disorder, like hypertension or depression, but usually results from a drug-drug interaction (either a pharmacokinetic or pharmacodynamic interaction between the drugs) between drugs that increase serotonin concentrations in the body. Serotonin syndrome commonly occurs when two serotonergic antidepressants with different mechanisms of action are taken together. For example, when a monoamine oxidase inhibitor (MAOI: eg. Parnate™ - tranylcypromine) is taken with a selective serotonin reuptake inhibitor (SSRI: Prozac™ - fluoxetine).

Serotonin syndrome is characterized by changes in autonomic nervous system, neuromotor, and cognitive-behavioral function. These changes manifest as the following symptoms:

An overactive autonomic nervous system results in excessive sweating (diaphoresis), increased body temperature (hyperthermia), increased blood pressure (hypertension), a rapid heartbeat (tachycardia), dilated pupils, shivering, nausea, and
diarrhea.

Overactive motor nerves result in hyperreflexia, involuntary muscle twitching and spasming of skeletal muscles (clonus) or groups of muscles (myoclonus), restlessness, tremor, a lack of coordination, rigidity, teeth chattering (or shivering), lockjaw (trismus), and seizures.

Cognitive-behavioral effects of serotonin syndrome include: confusion, agitation, anxiety, hypomania, insomnia, hallucinations, and headache.

Rarely serotnin syndrome can result in severe hyperthermia (increased body temperature) with complications such as disseminated intravascular coagulation (blood clotting throughout the body), rhabdomyolysis (breakdown of skeletal muscle), renal failure, coma, and death.

I have not heard of stuttering, depressive episodes, screaming or crying as a direct result of serotonin syndrome. While some people may be genetically sensitive to the effects of serotonin (and thus serotonergic agents), I have not heard of anyone who spontaneously acquired serotonin syndrome with no causative agent (eg. the ingestion of a serotonergic substance). I doubt that serotonin syndrome can be caused psychologically.

I hope that this is of some help. - Cam