Recently Answered Questions
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Query: Hi doctor, I have chest pain in the left side of my torso, which started last week. The pain radiates from the left side of my neck to the left arm, and it is burning, gnawing, and constant. The chest pain is accompanied by nausea, heart palpitations, higher heart rate, bowel disruptions, hoarsenes... Read Full »
Answer: Hi, Welcome to icliniq.com. I understand your concern. The change in the heart rate from 60 bpm (beats per minute) to 100 to 120 bpm can be due to various reasons such as anxiety, stress, fever, anemia, thyroid disorder, certain medicines, or the heart's electrical system abnormality. If it is due... Read Full »
Are sweating, dilated pupil and muscle stiffness side effects of Venlafaxine?
Query: Hello doctor, Today my sister, who is 22 years old, started taking Venlafaxine 75 mg, but after a couple of hours she felt nauseated and started sweating and got red cheeks as well. Now I notice that her pupils are dilated, and she has severe muscle stiffness. She has cerebral palsy, sitting in a wh... Read Full »
Dr. Mahmoud Ahmed Abdelrahman Abouibrahim
Answer: Hello, Welcome to icliniq.com. Sorry to know about your sister's symptoms. The symptoms you mentioned is for Serotonin syndrome which causes palpitations, muscle stiffness, hyperthermia, sweating, hyperactivity, and confusion. The mechanism is serotonin excess in the brain. It is one of the possib... Read Full »
Will lowering the dose of Tramadol and Priligy reduce the risk of serotonin syndrome?
Query: Hello doctor, I am taking 100 mg Tramadol and 60 mg Priligy (Dapoxetin) for the treatment of premature ejaculation before having sexual intercourse. The result is my intercourse time has increased from two minutes up to 45 minutes without having ejaculation. With Priligy or Tramadol alone it is ar... Read Full »
Answer: Hello, Welcome to icliniq.com. Serotonin syndrome will not occur when you consume high doses of SSRI (selective serotonin reuptake inhibitors) and then stop abruptly. My advice to you would be a safer way out. You should continue with Dapoxetine 60 mg and avoid Tramadol. If you do not get adequate... Read Full »
What foods to avoid in serotonin syndrome?
Query: Hello doctor, My 39-year-old son was hospitalized for five days with serotonin syndrome. He was given intravenous and Ativan. He was discharged from the hospital, and he will go to his doctor regarding his meds. The problem is he was never told if he needed to stay away from certain foods that might... Read Full »
Answer: Hello, Welcome to icliniq.com. Yes, it is true that diet is very difficult for patients with serotonin syndrome. But, there are many myths as well about diet. 1. Most cheese and cheese products nowadays are low in tyramine levels. So, they are not that harmful. To be called yogurt, milk must be ferm... Read Full »
Can Trazodone cause serotonin syndrome?
Query: Hello doctor, I weaned off of 40 mg of Paroxetine very slowly but my sleep was impacted and as of two months, I have been suffering from extreme insomnia. I have gone back to medication and I am currently on 20 mg of Paroxetine and 10 mg of Fluoxetine, but my insomnia has continued. I was prescribe... Read Full »
Answer: Hello, Welcome to icliniq.com. Serotonin syndrome is an acute emergency case, rarely seen in common practice. At least not when you have already been taking 40 mg of Paroxetine for years. Also, Trazodone is a safer and better sleep-inducing agent when it comes to being used for sleep. As per my ... Read Full »
How to prevent serotonin syndrome while taking antidepressants?
Query: Hi doctor, I am under treatment for OCD and anxiety symptoms. I have had very hard months with extreme anxiety, panic attacks and depersonalization. Now, I am on Duloxetine 60 mg (will stop in the next 7 weeks), Paroxetine 20 mg (will be reduced in the following weeks), Clomipramine hydrochloride... Read Full »
Dr. Saraswat Kumarshri Shriniwas
Answer: Hi, Welcome to icliniq.com. There is always a possibility of serotonin syndrome when two or more serotonergic antidepressants are being used.However, Clomipramine and an SSRI (selective serotonin reuptake inhibitor) like Paroxetine are frequently used together in resistant OCD (obsessive-compulsive ... Read Full »
Can Cymbalta and Phentermine be used together for weight loss?
Query: Hi doctor, I take Cymbalta 60 mg for depression and Trazodone 100 mg for sleep. Can I take Phentermine for weight loss without problems of serotonin syndrome? Read Full »
Answer: Hi, Welcome to icliniq.com. Phentermine is a short-term (few weeks) adjunctive used as a part of a weight reduction regimen for patients with initial body mass index (BMI) more than or equal to 30 kg/m². Cymbalta - Duloxetine has serious interaction with Phentermine. Both if taken togethe... Read Full »
I am experiencing tremors in my hands and feet after the dose of Zoloft was increased. Please help.
Query: Hi doctor, I have been taking Zoloft 50 mg for many years. About two weeks ago, the dose was increased to 100 mg, and I began taking Trazodone 50 mg at bedtime. Three days ago, the Zoloft was increased to 150 mg. Today I am primarily experiencing tremors in my hands and feet, but there is a general ... Read Full »
Answer: Hi, Welcome to icliniq.com. I understand your concern. Tremors are the side effect of the medication. Since Zoloft (Sertraline) dose was increased from 50 mg to 150 mg in the last two weeks along with the addition of another antidepressant, Trazodone (serotonin modulator) 50 mg, your body may hav... Read Full »
Is Effexor the reason for my low sexual drive?
Query: Hello doctor, Six years back, I was diagnosed with serotonin syndrome from an MDMA overdose. The very next year, my mother passed away. I was not myself; I took steroids. I felt confident towards the end of the cycle. I cry for no reason. Three years back, I had LSD-induced psychosis. For almost tw... Read Full »
Answer: Hi, Welcome to icliniq.com. Your past recurring episodes of depression say that you have to be on a mood stabilizer and antidepressants. Feeling high can be the other side of your polarity. Since you do not have any mood symptoms at present, I advise you to continue the medications prescribed, as ... Read Full »
Can hypertension and stress be due to serotonin syndrome?
Query: Hi doctor,My brother is 39 years old and has hypertension. His BP 145/98 normally. But sometimes his BP shoots up to 164/110. Yesterday his BP was 168/110. He was having no symptoms like palpitations or headache, though feeling a bit uneasy. He took Amlodipine 10 mg. After taking some rest, his BP w... Read Full »
Answer: Hi, Welcome to icliniq.com. Thanks for the query. Blood pressure is a dynamic entity; it is not static. It keeps changing throughout the 24 hours and vary during different activities and moods. The same is with heart rate. Fear, anger, fight, exertion, pain in the body, depression, and anxiety aff... Read Full »