
Took Roxycodone Along Wit Zoloft And Antihistamine. Itchy Rashes Appeared All Over Body. What Is Wrong?

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You are 41 years old female with past history of keratosis pilaris since childhood, squamous cell carcinoma removed about 7 year back, PUPPS also 7 years back. You are currently of Zoloft and antihistaminic. You also take sleep medicines.
About few weeks back you accidentally took Roxycodone 60 mg along with zoloft (Sertaline). Immediately after taking the medicines you developed itching, restlessness, vomiting, rashes on skin. After even a month of the episode the rash didn't go and it even become inflamed and you were compelled to take antibiotics to contain it. Almost all tests came normal. Now again you have started developing rashes which are polymorphic.
Now what actually happened?
Zoloft is a SSRI group drug. It acts in depression or anxiety by increasing serotonin in brain. They are other wise safe drugs with very less side effects. When taken with some drugs like TCAs or serotonergic drugs they can cause very high serotonin in body leading to serotonin syndrome. The syndrome is characterized by nausea, vomiting, itching, restlessness, irritability, dizziness, confusion, rashes etc symptoms. Recent studies has reported that it can occur with Opioid drugs also. So SSRI like zoloft when taken with any opioid drugs may result in serotonin syndrome. You have taken sertaline with roxycodone which resulted in Serotonin syndrome. The rash can last for weeks some times in susceptible persons.
As you have passed acute stage of symptoms still I will advise you to please visit your Doctor or Psychiatrist for expert opinion, because if they think the necessary dose adjustments can be done.
- The rash on your chest for secondary bacterial infection which resulted in inflammation. For rash I will advise you first to visit Psychiatrist and if he thinks that Dermatology opinion is must then visit a Dermatologist. Most likely the rash will go once the medicine dose will be decreased or medicine will be stopped.
Hope I solved your query, If you have more questions you can ask again.
Thanks
Dr. Seikhoo Bishnoi, MD
(Consultant Psychiatrist)

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