Adverse SSRI Reactions

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Adverse SSRI Reactions

 

Recent medical studies show that that the brain levels of Prozac are 100 times

greater than blood levels and it is believed that this is the case with the

other serotonin reuptake inhibitors as well - evidence of toxic brain levels

affecting behavior no matter what the blood levels demonstrate. As patients have

continued to report, this accumulation is evidence that accumulation of drug

residue will produce a delayed withdrawal and that it will continue to produce

reactions, not only during the period of time the patient is using the drug, but

for long periods of time after discontinuation of the drug use.

 

Brain wave patterns indicate patients are in a total anesthetic sleep state

while appearing awake and functioning. Increasing serotonin - exactly what these

drugs are designed to do - induces both nightmares and sleepwalk. Patients

report over and over again that they have lived out their worst nightmare. And

as with sleepwalk episodes, many have no recall or little recall of what they

have done. Often someone must prove to them what they have done while they where

under the influence of these drugs before they will believe it to be true. One

patient stated that he could not detect during his two year use of Prozac what

was real or what was a dream!

 

Seven to ten percent of patients do not have the liver function necessary to

metabolize these drugs. Unfortunately even if they do have a functioning P450

IID6 liver system to metabolize the drugs, this group of drugs totally saturates

that liver system so that the ability to metabolize the drug gradually becomes

greatly impaired and the metabolism of other drugs becomes greatly impaired.

 

Stress or depression can be detected by elevated levels of cortisol, yet one

single 30mg dose of Prozac clearly doubles the level of cortisol. This should in

the long run double the patient's stress and depression. But that is not the

only detrimental effect of elevated cortisol levels. This can cause a multitude

of serious physical and emotional adverse side effects.

 

Giving these drugs to children is absolutely unconscionable for many reasons.

One of the most obvious is that increased cortisol impairs the development and

regeneration of the liver, kidney and muscles, as well as impairing linear

growth. Yet, learning that even one parent was given this information would be

surprising. PROZAC: PANACEA OR PANDORA?--Ann Blake Tracy

 

Here is the complete list of adverse reactions attributable to SSRI medications:

 

Insomnia

Vivid and violent dreams

Inability to detect dreams from reality (The world takes on an other-worldly

aspect)

No emotions

Inability to feel guilt or cry

Nausea

Loss of appetite

Rash; Breathing or lung problems

Heart fluttering

Shaking - jitteriness

Unusual energy surges at times producing super human strength (adrenalin

rushes)

Memory impairment

Hair loss

Blurred vision or pressure behind the eyes

Inability to discontinue use of drug and increasing own dose

Cravings for alcohol, sweets, and other substances or drinking large sums of

alcohol, coffee or other caffeinated drinks, diet pop with NutraSweet, etc.

Headaches

Swelling and/or pain in joints

Burning or tingling in extremities

Muscle twitching or contractions

Tongue numbness and slurred speech

Sweating

Dizziness

Confusion

Chills or cold sweats

Muscle weakness

Extreme fatigue

Diabetes or hypoglycemia

Lowered immune system

Seizures or convulsions

Weight gain or weight loss

Mood swings

Altered personality

Symptoms of mania, ie., inability to sit still or restlessness, racing

thoughts, acting silly or giddy (like a teenager again)

Sexual promiscuity leading to unwanted pregnancy or divorce

Irresponsibility, wild spending sprees, gambling, criminal behavior,

shoplifting, embezzling, stealing, hostility, etc.

Deceitfulness

Blank staring

Inability to see any alternatives in situations

Hyperactivity

Aggressive or violent behavior

Wanting to ram other cars or driving irrationally

Impulsive behavior with no concern about consequences

Numbness in various body parts - legs go numb and right out from under

patient

Sexual organs go numb making orgasm impossible

Pulling away from loved ones and others (isolating oneself)

Divorce

No desire to be touched

Paranoia

Falsely accusing others of abuse - family members or acquaintances

Loss of spirituality

Feeling " possessed " or that something evil is inside

Self destructive behavior and suicidal ideation

Suicide attempts

Muscle tremors

Loss of co-ordination

Mania

Psychosis

 

[sOURCE: PROZAC: PANACEA OR PANDORA?, BY ANN BLAKE TRACY, PH.D.]

 

Prozac Label (September, 1988)

 

Here is the information as it written on the label insert for Prozac:

 

Body as a Whole---Frequent: chills; Infrequent: chills and fever, face edema,

intentional overdose, malaise, pelvic pain, suicide attempt: Rare: abdominal

syndrome acute, hypothermia: intentional injury, neuroleptic malignant syndrome,

photosensitivity reaction.

 

Cardiovascular System ---Frequent: hemorrhage, hypertension: Infrequent: angina

pectoris, arrhythmia, congestive heart failure, hypotension, migraine,

myocardial infarct, postural hypotension, syncope, tachycardia, vascular

headache: Rare: atrial fibrillation, bradycardia, cerebral embolism, cerebral

ischemia, cerebrovascular accident, extrasystoles, heart arrest, heart block,

pallor, peripheral vascular disorder, phlebitis, shock, thrombophlebitis,

thrombosis, vasospasm, ventricular arrhythmia, ventricular extrasystoles,

ventricular fibrillation.

 

Digestive System---Frequent: increased appetite, nausea and vomiting:

Infrequent: aphthous stomatitis, cholelithiasis, colitis, dysphagia, eructation,

esophagitis, gastritis, gastroenteritis, glossitis, gum hemorrhage,

hyperchlorhydia, increased salivation, liver function tests abnormal, melena,

mouth ulceration, nausea/vomiting/diarrhea, stomach ulcer, stomatitis, thirst:

Rare: biliary pain, bloody diarrhea, cholecystitis, duodenal ulcer, enteritis,

esophageal ulcer, fecal incontinence, gastrointestinal hemorrhage, hematemesis,

hemorrhage of colon, hepatitis, intestinal obstruction, liver fatty deposit,

pancreatitis, peptic ulcer, rectal hemorrhage, salivary gland enlargement,

stomach ulcer hemorrhage, tongue edema.

 

Endocrine System---Infrequent: hypothyroidism: Rare: diabetic acidosis, diabetes

mellitus.

 

Hemic and Lymphatic system---Infrequent: anemia and ecchytmosis: Rare: blood

dyscrasia, hypochromic anemia, leukopenia, lymphedema, lymphocytosis, petechia,

purpura, thrombocythemia, thrombocytopenia.

 

Metabolic and Nutritional---Frequent: weight gain; Infrequent: dehydration,

generalized edema, gout, hypercholesteremia, hyperlipemia, hypokalemia,

peripheral edema; Rare: alcohol intolerance, alkaline phosphatase increased, BUN

increased, creatine phosphokinase increased, hyperkaltemia, hyperuricemia,

hypocalcemia, iron deficiency anemia, SGPT increased.

 

Musculoskeletal System---Infrequent: arthritis, bone pain, bursitis, leg cramps,

tenosynovitis: Rare: arthrosis, chondrodystrophy, myasthenia, myopathy,

myositis, osteomyelitis, osteoporosis, rheumatoid arthritis.

 

Nervous System---Frequent: agitation, amnesia, confusion, emotional lability,

sleep disorder; Infrequent: abnormal gait; acute brain syndrome, akathisia,

apathy, ataxia, buccoglossal syndrome, CNS depression, CNS stimulation,

depersonalization, euphoria, hallucinations, hostility, hyperkinesia,

hypertonia, hypesthesia, incoordination, libido increased, myoclonus, neuralgia,

neuropathy, neurosis, paranoid reaction, personality disorder*, psychosis,

vertigo; Rare: abnormal electroencephalogram, antisocial reaction, circumoral

paresthesia, coma, delusion, dysarthria, dystonia, extrapyramidal syndrome, foot

drop, hyperesthesia, neuritis, paralysis, reflexes decreased, reflexes

increased, stupor.

 

Respiratory System---Infrequent: asthma, epistaxis, hiccup hyperventilation:

Rare: apnea, atelectasis, cough decreased, emphysema, hemoptysis,

hypoventilation, hypoxia, larynx edema, lung edema, pneumothorax, stridor.

 

Skin and Appendages---Infrequent: acne, alopecia, contact dermatitis, eczema,

maculopapular rash, skin discoloration, skin ulcer, vesiculobullous rash; Rare:

furunculosis, herpes zoster, hirsutism, petechial rash, psoriasis, purpuric

rash, pustular rash, seborrhea.

 

Special Senses---Frequent: ear pain, taste perversion, tinnitus; Infrequent:

conjunctivitis, dry eyes, hydriasis, photophobia; Rare: blepharitis, deafness,

diplopia, exophthalmos, eye homorrhage, glaucoma, hyperacusis, iritis, parosmia,

scleritis, strabismus, taste loss, visual field defect.

 

Urogenital System--Frequency: urinary frequency; Infrequent: abortion,

albuminuria, amenorrhea, anorgasmia, breast enlargement, breast pain, cystitis,

dysuria, female lactation, fibrocystic breast, hematuria, leukorrhea,

menorrhagia, metorrhagia, nocturia, polyuria, urinary incontinence, urinary

retention, urinaryurgency, vaginal hemmorrhagia, Rare: breast engorgement,

glycosuria, hypomenorrhea, kidney pain, oliguria, priapism, uterine hemmorrhage,

uterine fibroids enlarged.

 

*Personality disorder is the COSTART term for designating non-aggressive

objectional behavior.

 

Postintroduction Reports: Voluntary reports of adverse events temporally

associated with Prozac that have been received since market introduction and

that may have no causal relationship with the drug include the following:

aplastic anemia, atrial fibrillation, cerebral vascular accident, cholestatic

jaundice, confusion, dyskenesia (including, for example, a case of

buccal-lingual-masticatory syndrome with involuntary tongue protrusion reported

to develop in a 77-year old female after 5 weeks of fluoxetine therapy and which

completely resolved over the next few months following drug

discontinuation),eosinophilie pneumonia, epidermal necrolysis, erythema nodosum,

exfoliative dermatitis, gynecomastia, heart arrest, hepatic failure/necrosis,

hyperprolactinemia, immune-related hemolytic anemia, kidney failure,

misuse/abuse, movement disorders developing in patients with risk factors

including drugs associated with such events and worsening of preexisting

movement disorders, neuroleptic malignant syndrome-like events, pancreastitis,

pancytopenia, priapism, pulmonary embolism, QT prolongation, Steven-Johnson

syndrome, sudden unexpected death, suicidal ideation, thrombocytopenia,

thrombocytopenic purpura, vaginal bleeding after drug withdrawal and violent

behaviors.

 

Hyperserotonemia

 

Hyperserotonemia (elevated serotonin levels) can produce very serious

complications medically, as well as serious neurologic and psychiatric

disorders. Carcinoid syndrome and the serotonin syndrome are two medical

conditions in which elevated serotonin levels are present. Carcinoid syndrome is

a set of symptoms caused by the secretion of serotonin by carcinoid tumors,

prostaglandins, etc. Symptoms include attacks of severe cyanotic flushing of the

skin lasting from minutes to days, diarrhea, bronchoconstrictive attacks, sudden

drops in blood pressure, edema, and ascites, which is an abnormal accumulation

of serous fluid in the abdominal cavity, also known as abdominal or peritoneal

dropsy. [From PROZAC: PANACEA OR PANDORA?, Pg. 87.]

 

Serotonin Syndrome

 

The serotonin syndrome is a hyperserotonergic state which is a very dangerous

and a potentially fatal side effect of serotonergic enhancing drugs which can

have multiple psychiatric and non-psychiatric symptoms. It is a condition which

has been on the rise since the 1960's when we began using more and more drugs

which directly affect serotonin. This is a toxic condition which requires

heightened clinical awareness in order to prevent, recognize, and treat the

condition promptly. Promptness is vital because, as we just mentioned, the

serotonin syndrome can be fatal and death from this side effect can come very

rapidly. This syndrome is a toxic hyperserotonergic state whose rate of

incidence is unknown, but is on the rise. The suspected cause of that increase

is the introduction of the new selective serotonergic enhancing agents in

clinical practice - the SSRIs. This disorder, brought on by excessive levels of

serotonin, is difficult to distinguish from the neuroleptic malignant syndrome

because the symptoms are so similar. The neuroleptic malignant syndrome is a

serious condition brought on by the use of the neuroleptic drugs.

 

The symptoms of the serotonin syndrome are (from The Serotonin Syndrome, AM J

PSYCHIATRY, June 1991):

 

Euphoria

Drowsiness

Sustained rapid eye movement

Overreaction of the reflexes

Rapid muscle contraction and relaxation in the ankle causing abnormal

movements of the foot

Clumsiness

Restlessness

Feeling drunk and dizzy

Muscle contraction and relaxation in the jaw

Sweating

Intoxication

Muscle twitching

Rigidity

High body temperature

Mental status changes were frequent (including confusion and hypomania - a

" happy drunk " state)

Shivering

Diarrhea

Loss of consciousness and death.

 

The serotonin syndrome is generally caused by a combination of two or more

drugs, one of which is often a selective serotonergic medication. The drugs

which we know most frequently contribute to this condition are the combining of

MAOIs with Prozac (this should also include the other SSRIs) or other drugs that

have a powerful effect upon serotonin, ie., clomipramine (Anafranil), trazadone

(Deseryl), etc. The combination of lithium with these selective serotonergic

agents has been implicated in enhancing the serotonin syndrome. The tricyclic

antidepressants, lithium, MAOIs, SSRIs, ECT (electric shock treatment),

tryptophan, and the serotonin agonists (fenfluramine) all enhance serotonin

neurotransmission and can contribute to this syndrome. Anything which will raise

the level of serotonin can bring on this hyperserotonergic condition. The

optimal treatment for the serotonin syndrome is discontinuation of the offending

medication or medications, offer supportive measures, and wait for the symptoms

to resolve. If the offending medication is discontinued, the condition will

often resolve on its own within a 24 hour period. If the medication is not

discontinued the condition can progress rapidly to a more serious state and

become fatal. It should be apparent that the greater the enhancement of

serotonin levels, the greater the chances of producing the serotonin syndrome.

Therefore it is recommended that Zoloft, Prozac, Paxil, Luvox, Serzone, etc. not

be used concurrently with each other or any other serotonergic drugs and that

these serious adverse reactions should be expected with these combinations

(Callahan, 1993). [PROZAC: PANACEA OR PANDORA?, p. 88.]

 

 

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