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What Does Serotonin Syndrome Mean?
I am on Sertraline, 25 mgs per day and Clonzapam, 2 per day, am and pm if needed. 1mg. I went to dr and ended up with bronchitis and sinus infection. Was given Percocet for pain. Are these safe to take together? What is Serotonin Syndrome and do I have to worry about that?
posted on
Sat, 30 Aug 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 31 Oct 2014
Answered on
Mon, 3 Nov 2014
Last reviewed on
Hello,
Welcome to HCM and thank you for your query.
Oxycodone in Percocet can produce adverse reactions with Sertaline. Both have synergism and increase the blood level of each other. Increase in Sertaline level has the potential of producing serotonergic syndrome. It may have a wide range of clinical manifestations. Mild symptoms may consist of increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor or twitching), as well as overresponsive reflexes.
In more severe cases ,additional abnormalities such as hyperactive bowel sounds, high blood pressure and hyperthermia; a temperature as high as 40 °C (104 °F), overactive reflexes and clonus may occur. Mental changes include hypervigilance or insomnia and agitation. Severe symptoms include severe increases in heart rate and blood pressure that may lead to shock. Temperature may rise to above 41.1 °C (106.0 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation.
These are unlikely to occur in most cases, but is a possibility. If the pain is not severe, I recommend my patients to take only paracetamol and to avoid opiates.
Oxycodone also increases the sedative effect of clonazepam.
If you have further queries, I am available at HCM web site.
Take Care
Dr. Noble Zachariah
Welcome to HCM and thank you for your query.
Oxycodone in Percocet can produce adverse reactions with Sertaline. Both have synergism and increase the blood level of each other. Increase in Sertaline level has the potential of producing serotonergic syndrome. It may have a wide range of clinical manifestations. Mild symptoms may consist of increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor or twitching), as well as overresponsive reflexes.
In more severe cases ,additional abnormalities such as hyperactive bowel sounds, high blood pressure and hyperthermia; a temperature as high as 40 °C (104 °F), overactive reflexes and clonus may occur. Mental changes include hypervigilance or insomnia and agitation. Severe symptoms include severe increases in heart rate and blood pressure that may lead to shock. Temperature may rise to above 41.1 °C (106.0 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation.
These are unlikely to occur in most cases, but is a possibility. If the pain is not severe, I recommend my patients to take only paracetamol and to avoid opiates.
Oxycodone also increases the sedative effect of clonazepam.
If you have further queries, I am available at HCM web site.
Take Care
Dr. Noble Zachariah
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