Serotonin Syndrome and Withdrawals

After I had W, I had post partum depression.  Before Isaac was born, my doctor and I made a medication plan to be proactive about what was to come.  I had been on 40mg of fluoxetine before Isaac was born (this was a lower dose than I was on when I was pregnant with W)  so we just bumped it up to 60mg in hope that that would help.  I also had plans to meet with my mental health worker as well.

A few weeks after Isaac was born, I noticed a downward trend in my mood.  I went back to my doctor to see what we could do to help make things easier on me.  We decided to go with the combination that helped with my postpartum with W: 80mg of Fluoxetine and 300mg of Wellbutrin. We knew that both of these medications take time to get into your system, so I wouldn’t feel the full effect until being on them for 4-6 weeks.

As I waited out the 4-6 weeks, physical symptoms got worse and mental symptoms didn’t improve. I felt like I was vibrating constantly, had deafening ringing in my ears, developed spots on my skin and I would get so dizzy.  I just rode those symptoms out hoping they would go away soon.  But then the suicidal thoughts started coming.  

I had another doctor appointment on the 7th of March, and I expressed my concerns.  We saw that this course of treatment wasn’t working for me this time around, and decided to try an entirely new medication; Escitalopram.  Trying to avoid withdrawal symptoms, we decided to do a fast taper to try and get the old meds out of my system as fast as we could, but not make me feel crappy while doing it. I took the new regiment on the night of the 7th.

I woke up on the 8th feeling like I had been poisoned.  I immediately knew something was wrong.  Cody took me to the closest emergency room.  I explained to the nurses about the medication changes that we had made and the symptoms I was experiencing: I was so dizzy I had almost fallen a few times that morning, my whole body was shaking, I had muscle spasms all over my body, my heart was racing, and I was so nauseous.

The nurses phoned over to the doctor and the doctor immediately knew I was going through serotonin syndrome (this is basically when you have toxic levels of serotonin in your blood).  If you would like to read more about it click here.

I was treated with IV fluids and a medication that would help calm my body down and reduce the shaking that was happening.  I was kept for 10 hours to make sure this form of treatment was working as they were worried about seizures.  After those 10 hours, I was feeling better and was sent home.  The plan was to completely stop the fluoxetine, continue tapering the Wellbutrin and continue the Escitalopram.

Over the next couple of days I felt better.  I thought I was through the worst of it until I woke up on the 11th.

I woke up with my whole body shaking again, feeling dizzy and nauseous.  Cody took me back to the emergency room, and we met with the doctor on call.  I was worried that It was serotonin syndrome again, but since we decreased my dose that wasn't the case.  I was now going through withdrawals.

I was treated with IV fluids and medications to manage the symptoms, but there was nothing else we could do either than just ride it out.

I used whatever fight I had left in me to get through the rest of the day on the 11th and the 12th.

To be continued…