My Battle with Serotonin Syndrome

Just a little to know before you read the story. I’ve been taking an antidepressant for 18 years. I thought that it might be time to switch it up and try different one since the previous one (Prozac) had seemed to peter out just a bit. No biggie, right?

Wrong!

I went to my GP and told her I’d like to switch to a different antidepressant and she was quick to prescribe Viibryd, a brand new SSRI on the market. Immediately, I was concerned because even though it has been FDA approved, I tend to like to stick to the older, more well known drugs. I should have listened to my gut. I didn’t though and it put me in a world of hurt about 10 days later.

So…here’s my Viibryd saga.

May 17th - I discontinued Prozac as instructed by my doc and started Viibryd at 10mg. I had a few minimal bouts of diarrhea. Nothing to write home about, but enough to notice.

May 24th - Upped Viibryd to 20 mg to eventually titrate up to 40 mg.

May 26th - Friday morning I took Imitrex for an oncoming migraine and continued on with the 20 mg Viibryd.

May 27th - Saturday morning I took another Imitrex for migraine management. That night I experienced extreme cold for about four hours. This was a bone-crushing cold that six blankets and an inside temp of 80 couldn’t warm me up. It was so bizarre. Generally with my flares of ankylosing spondylitis, I do get a little cold and then a fever, but then I have pain with it. This was nowhere near any degree of cold I’ve ever felt before, but I didn’t have any pain so I didn’t think this was going to be a run of the mill type flare for me.

After about four hours of the extreme cold, the fever came on without any mercy.  I was sweating through my clothes and sheets and begging for mercy from whoever it was that could hear me. I really felt like I was going crazy! My breathe felt like fire on my face. I felt like I was cooking from the inside out. Had I been in control of anything at the time, I would’ve know I needed to go be seen. During this fever from hell I had extreme diarrhea (AKA fountain butt) and felt extremely nauseous, but couldn’t throw up. Every sip of water I took or every move I made meant I had to run straight to the bathroom. This could pretty much be the worst night of my life!

I must’ve been in and out of sleep because I don’t remember the sun rising.

May 28th – I was grateful to wake up Sunday and be pretty much fever free, but the diarrhea was not stopping and I wasn’t able to keep anything, not even a sip of water, in my body. I figured I had a bad bout with a stomach virus at this point. The cold/fever/incoherent thing really threw me for a loop though because I’ve never had anything like it.

May 29th - Monday morning I went to urgent care because I hadn’t been able to keep a single drop of water down since Saturday night. When I arrived at urgent care, my blood pressure was 160/140 (it’s normally about 125/80)! My resting pulse was 122! It was insane! They had trouble finding a good vain, but when they did, the started the fluids and nausea meds and I felt so much better. I was able to drink a sip of water and thought I’d be ok.

Once I got home the diarrhea started back in full force. This continued on and on and on. I was so weak!

The urgent care doc and nurses were great. He said all of my blood work came back normal and that his conclusion was that it was serotonin syndrome due to the new and increased dose of Viibryd interacting with the Imitrex (a triptan). The crazy high blood pressure, pulse, hyper/hypothermia, nausea, and diarrhea were due to too much serotonin in my brain. Crazy! And to think I was never warned by my doc or pharmacist that this could be an issue, a life-threatening one, at that!

May 31st – When I woke up I knew I couldn’t go on like this anymore; I didn’t even have enough energy to keep my eyes open! My body desperately needed hydration. I went to my doc who prescribed the Viibryd (and did NOT tell me about any possible interactions with the triptan I took). They stuck me 10 times (two times in the foot) to find a vain that didn’t “blow” to get the IV fluids in me. Once I got the fluids in me I felt so much better again.

June 2nd – One week had gone by and I was finally starting to feel like I was going to make it! I finally was able to eat a little something (pretzels) and not be repulsed by it or have it come out the other end.

June 3rd – I woke up and felt like I was a new person! I had wanted a way to kick-start a diet, but losing about 15 pounds by being sicker than a dog is not what I expected!

The moral of this story I guess is to really make sure to 1) follow your gut instinct and 2) make sure to check with your doctor or pharmacist about potential drug interactions. What really gets me is that I am normally very good about following my gut and double-checking with the doc or pharmacist about any possible reactions. I know that from now on, I’ll make sure to do both of these things!

Thanks for listening!

Sarah:)