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Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3706
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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Could serotonin toxicity syndrome develop even after years

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Could serotonin toxicity syndrome develop even after years of steady doseage of zoloft and xanax?

Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I have worked in concert with Board Certified Child, Adolescent & Adult Psychiatrists throughout my career

Bill :

Serotonin syndrome is a potentially life threatening drug reaction that causes the body to have too much serotonin, a chemical produced by nerve cells.

Bill :

This syndrome can occur with monotherapy (taking one medication in the class of SSRI or SNRI) but typically is the result of use of two medications ( in different classes) as described in the link above.

Bill :

"The diagnosis is made on clinical grounds in patients who have taken one or more agents that are presumed to ‘increase’ serotonin "

Customer:

Lately i have felt the need to increase my xanax intake.. do you know if the combination of Zoloft and Xanax could produce this?

Bill :

Xanax is a Benzodiazapine which is of a class that is typically used to treat this syndrome.

Customer:

Treat as opposed to CAUSE this syndrome?

Bill :

Symptoms of the syndrome upon proper diagnosis and treatment will typical abate within 24-48 yours however their can be some prolonged symptoms.

Bill :

Treatment of Seratonin Sydrome is describe in detail in the above link:

Bill :

copied again above.

Bill :

Additional information on the treatment of Serotonin Syndrome is here:

Bill :

Is there anything else I can help with today?

Customer:

Okay i will read further.. the reason i ask is that im noticing slightly different reaction to the xanax recently-- though after 10 years i am still on a relatively low dose (1MG as needed).. 150mg of Zoloft nightly as well for at least 5 years-- just my final question--- such steady use-- this syndrome is not likely to develop all of a sudden- correct?

Bill :

This syndrome can develop at any time as explained in the medical literature above. It would be more likely to come from the Zoloft vs the Xanax.

Bill :

If I were you, I would double check with the prescribing Doctor just to make sure- You will also feel better.

Bill :

Call your Doctor today as he/she is best suited respond to your unique needs. Can you do that?

Customer:

I will do that first thing in the morning.. last thing i promise-- should the zoloft be causing some level of this syndrome-- would the xanax be dangerous in combination?

Customer:

would it INCREASE the toxicity?

Bill :

Actually, Xanax, a benzodiazapine is in the class that would be used to treat Serotonin Syndrome and therefore is not likely to be a factor at all.

Bill :

From what you write, a "slight" difference in the way you have been experiencing the medication

Bill :

is not suggestive of an acute Serotonin Syndrome- However, talking to your Doc will reassure you.

Customer:

okay i can breathe easier now thank you very much for your help i will follow up with my doctor in the morning. thank you very much!

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