How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Chris C. Your Own Question

Chris C.
Chris C., Nurse
Category: Health
Satisfied Customers: 956
Experience:  Nurse with with 10+ yrs. in wellness care, geriatrics, hospice and acute care.
66637759
Type Your Health Question Here...
Chris C. is online now
A new question is answered every 9 seconds

How long does it take for brain chemistry to normalise after

Customer Question

How long does it take for brain chemistry to normalize after taking medications such as tramadol, 5-htp, codeine, St. John's wort, and ibuprofen. I have been taking all these at different times over the past 8 weeks, starting with a visit to the hospital for shoulder pain/chest pain, and given tramadol 50mg, which made me very high on just one tablet!!! I ceased taking it after 3 tablets because I preferred the pain to the feelings of being high on tramadol!! I have since developed symptoms of bad anxiety including brain fog, palpitations, internal tremors, insomnia, lump in throat, headaches, digestive cramps mild depression (as a result of anxiety I think), neck/shoulder pain, and body twitches.. Previously I took serc 24mg for diagnosed labyrinthitis which helped earlier attacks, but now when taking these meds, I get a buzzed/head rush when taking any histamine based medications, which never happened before!!! I rely on them in summer for allergies!! I visited a doctor and was diagnosed as depressed and anxiety, put on citalopram 20mg, but refuse to accept this diagnosis as I am usually relatively stress free and rarely anxious, and never to the degree of having a physical presentation. I am not taking the citalopram and have been feeling a little better, simply taking a multi-vitamin and eating well! Could the doctors diagnosis be wrong (given that it was made in 5 mins) and what alternative theories are there to follow up on? Thank you


 


Further background info:


 


Weight: 101.9kg


Height: 178cm


Diet:   Previously High Sugar Intake, reduced recently, mostly via white sugar in food. Generally Balanced Diet otherwise.  


Activity Level: Low - lethargic most of the time!


 


 

Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.

Greetings Mark.

How is your shoulder and chest pain?
Were any investigations done?

Dr. Arun

Expert:  Chris C. replied 1 year ago.
St. John’s wort has quite a few interactions with other medicines:
St. John's wort should only be used carefully with other antidepressants such as MAOIs, SSRIs (e.g. citalopram, fluoxetine, paroxetine, sertraline), tricyclics (e.g. dosulepin, imipramine, lofepramine), duloxetine or venlafaxine.
St. John's wort can sometimes decrease the effect of antiretrovirals (e.g. atazanivir, maraviroc, in dinavir; used to treat HIV), carbamazepine, ciclosporin, digoxin, methadone, omeprazole, oral contraceptives, phenobarbital, phenytoin, tacrolimus, theophylline, verapamil or warfarin.
St. John's wort can increase the effect of some triptans (e.g. sumatriptan, zolmitriptan; for migraine)

It is unwise to stop taking it suddenly, even if you feel better. Your symptoms can return if treatment is stopped too early. This may occur some weeks or even months after St. John’s wort has been stopped. When the time comes, you should withdraw St. John’s wort by a gradual reduction in the dose over several weeks. You should discuss this fully with your doctor, nurse or pharmacist.
Withdrawl symptoms from St. John's Wort include dizziness, confusion, "brain zaps", photosensitivity, headaches, and muscle aches.

Not all of these symptoms happen in everyone but these are the most common.

Do not take 5-hydroxytryptophan without the advice of a healthcare provider if you are using any of the following medications:

  • dextromethorphan (cough medicine);

  • St. John's wort;

  • an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), citalopram (Celexa), clomipramine (Anafranil), doxepin (Sinequan), fluoxetine (Prozac), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone (Desyrel), and others;

  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);

  • medicine to treat Parkinson's disease, such as carbidopa/levodopa (Atamet, Parcopa, Sinemet); or

  • prescription pain medication such as meperidine (Demerol), pentazocine (Talwin), or tramadol (Ultram, Ultracet).

5-HTP will cause exactly what you describe when combining it with ultram and when you add St. John's Wort into the mix you have a very bad cocktail that will cause the symptoms you describe.

It can take several weeks for your body to normalize from taking these medications and as a result depression type symptoms may be experienced as well as "brain zaps", anxiety, tremors, confusion, muscle cramps, stomach ailments, weakness, and others.

This is all related to the cocktail and drug interactions in what you were taking. These will also interact with betahistine as well.

Once the mix is out of your system cleared of these medications and your body has time to normalize neurotransmitter levels you should not have the reactions to the ultram or betahistine. This can take several weeks.
Customer: replied 1 year ago.

Thank you for your help so far, but after several weeks I am still experiencing discomfort under the collarbone and radiating toward the heart, especially early in the morning and in the evening.


 


Also general extreme fatigue, trouble with any effort related exercise (climbing 3 or 4 sets of of stairs makes me exhausted). Sleeping patterns have returned to semi-normal (5/6 hours per night instead of insomnia) where usually I had trouble waking up after 8 hours+. I am also feeling generally cold (despite the heat being turned on to 28 degrees C inside apartment) where previously I felt hot and sweaty much of the time.


 


Anxiety issues are much reduced. My stomach occasionally feels like it's "fizzing". I have stopped taking all medications and supplements. My pulse regularly drops to 52 bpm during these episodes (picked up by the ER doctor on first visit (sinus brachycardia with S1Q3T3 morphology, normal axis, no hypertrophy, no ischaemic signs noted). They checked for blood clots, nothing found on troponin or D-dimer (normal <190), also CXR normal and released me without further tests.


 


I am eating well and regularly on a balanced diet, with little stress or to be anxious about.


 


I know that some of these remaining symptoms can be cardiac related but also read that it might be an endocrin issue, or .... something else....


 


Your thoughts and advice are greatly appreciated...

Expert:  Chris C. replied 1 year ago.
Each individual may have different times to be completely clear and back to a "normal" state. Some of these symptoms are likely related to the medication discontinuation but some could be related to another problem like a thyroid issue, etc. With the symptoms continuing you should get to your doctor and have some blood test ran for thyroid, etc to make sure there are not multiple problems going on.
Chris C., Nurse
Category: Health
Satisfied Customers: 956
Experience: Nurse with with 10+ yrs. in wellness care, geriatrics, hospice and acute care.
Chris C. and 5 other Health Specialists are ready to help you
Customer: replied 1 year ago.
Can thyroid issues give calf pain in both legs (rating pain 5/10)??? I'm in agony and no idea how to reduce pain 11(had myself checked for dvt today) but no explanation! Pain is constant (resting/walking)
Expert:  Chris C. replied 1 year ago.
Yes, thyroid issues commonly cause muscle pain. This link will give you some great additional information:

http://thyroid.about.com/cs/symptomsproblems/a/pain.htm

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery