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Have Serotonin Syndrome And On Ativan. What Do You Recommend?

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Posted on Mon, 25 Nov 2013
Question: has been suggested that I have serotonin syndrome or toxicity. I was hospitalized, treated with the reversal and have been on Ativan for a few day. although the symptoms are less, they are not gone. I had read that they are usually over I 24 hours. Its been 7 days now. I've stopped the Elavil I was taking for pain for years which was extremely effective. the problem started when my hcp gave me tramadol. when should this end or is this something else
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Answered by Dr. Dr. Basheer Ahamed (5 hours later)
Brief Answer: Serotonin Syndrome. Detailed Answer: Hello, Welcome to XXXXXXX Thanks for your query. Usually milder form of Serotonin syndrome goes off within 24 hours of stopping the drug which causes serotonin to increase in the body. Sometimes drugs to stop serotonin secretion may also be needed. When the antidepressants are the offending drug like in your case(Elavil-Amitriptyline). It can take several weeks to go off. Because it stays in the system longer then other drugs in the system. In this situation I would advice my patients to wait and watch. If the symptoms does not improve in a couple of weeks then consult your doctor. Continue ativan in that period. If the symptoms worsens then hospitalisation and treatment with oxygen and I.v fluids are advised. Hope the answer helps you. Let me know if there is any clarification. Regards.
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Above answer was peer-reviewed by : Dr. Prasad
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Dr. Dr. Basheer Ahamed

Pathologist and Microbiologist

Practicing since :2006

Answered : 1584 Questions

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Have Serotonin Syndrome And On Ativan. What Do You Recommend?

Brief Answer: Serotonin Syndrome. Detailed Answer: Hello, Welcome to XXXXXXX Thanks for your query. Usually milder form of Serotonin syndrome goes off within 24 hours of stopping the drug which causes serotonin to increase in the body. Sometimes drugs to stop serotonin secretion may also be needed. When the antidepressants are the offending drug like in your case(Elavil-Amitriptyline). It can take several weeks to go off. Because it stays in the system longer then other drugs in the system. In this situation I would advice my patients to wait and watch. If the symptoms does not improve in a couple of weeks then consult your doctor. Continue ativan in that period. If the symptoms worsens then hospitalisation and treatment with oxygen and I.v fluids are advised. Hope the answer helps you. Let me know if there is any clarification. Regards.