Common "Serotonin Syndrome" queries answered by top doctors | iCliniq

Serotonin Syndrome

Serotonin syndrome is when high levels of serotonin get accumulated in the body due to taking certain drugs. It occurs when two serotonergic drugs like SSRI (selective serotonin reuptake inhibitors), MAOI (monoamine oxidase inhibitors), tricyclic antidepressants, etc., are taken together. It causes symptoms like restlessness, confusion, rapid pulse, diarrhea, and tremors.

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I am on medications for premature ejaculation. Please help.

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 arou...  Read Full »

Dr. Anshul Varshney

Answer: Hello, Welcome to 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 »

My son has serotonin syndrome. What should he eat?

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 »

Dr. Janrao Smit Uttam

Answer: Hello, Welcome to 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 »

Why do I get too wet during sex?

Query: Hello doctor, I am a 39-year-old female. For the last four years, whenever my partner and I have sex, I get too wet. It is so that neither one of us can feel anything. I have been to the gynecologist. She told it was because of my Bartholin's glands, and they froze them. But that did not work. Aga...  Read Full »

Dr. Purushottam Sah

Answer: Hello, Welcome to It is not due to anything related to your physical anatomy. If there were anything abnormal physically, then you would get wet apart from sex too. It may be related to hyperstimulation. Prozac (Fluoxetine) has sexual side effects, usually calming but maybe stimulato...  Read Full »

My sister is using Venlafaxine. Are there any side effects?

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 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 »

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 »

Dr. Suresh Kumar G D

Answer: Hi, Welcome to 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 have d...  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 1...  Read Full »

Dr. Saraswat Kumarshri Shriniwas

Answer: Hi, Welcome to 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-compulsiv...  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 »

Dr. Srivastava, Sumit

Answer: Hi, Welcome to Phentermine is a medication that is typically used for a short period of time, usually a few weeks, as an adjunctive treatment for weight reduction in patients with an initial body mass index (BMI) equal to or greater than 30 kg/m². Cymbalta, which contains the active in...  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 »

Dr. Padmapriya Chandran

Answer: Hi, Welcome to 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 »

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