4 B
SIUSLAW NEWS |
SATURDAY, APRIL 8, 2017
TO YOUR
GOOD HEALTH
Serotonin
Syndrome Affects
Mood, Muscles
DEAR DR. ROACH: After
being on Paxil for about 15 years, it
wasn’t working anymore. My doc-
tor decreased my dose, and I slowly
started Viibryd. The fi rst week I
felt great. When I increased the
dose of Viibryd, I began feeling
sick. I had a bad headache, anxiety
and couldn’t sleep, and my muscles
began jerking. I went to the doctor,
and she had me stop immediately,
prescribed Deplin for seven days,
and said that I’d had serotonin syn-
drome.
When I looked it up, I found it can
be fatal if the SSRI is not stopped. I
was off all SSRIs for about 10 days
but started feeling unconfi dent and
fragile, so I began taking 25 mg of
Paxil CR. My doctor seemed con-
cerned that the serotonin syndrome
could return, and advised me to take
Deplin along with the Paxil. How
common is this syndrome? I am
SALOME’S STARS
ARIES (March 21 to April 19) Th e
Lamb loves to be surrounded by fl ocks
of admirers. But be careful that some-
one doesn’t take his or her admiration
too far. Use your persuasive skills to let
him or her down easily.
TAURUS (April 20 to May 20)
Th is is a good time to begin setting
far-reaching goals and connecting
with new contacts. Aspects also favor
strengthening old relationships -- per-
sonal and/or professional.
GEMINI (May 21 to June 20) A
personal disappointment should be
viewed as a valuable learning experi-
ence. Go over what went wrong and
see where a change in tactics might
have led to a more positive outcome.
CANCER (June 21 to July 22) Don’t
leave projects unfi nished or personal
weaning myself off the Paxil, but
what if I need an antidepressant?
-- M.M.
ANSWER: Serotonin syndrome
is more common than often is
suspected. It is an abnormality of
brain chemistry caused most often
by medications, especially selec-
tive serotonin reuptake inhibitors
(SSRIs), like paroxetine (Paxil) and
vilazodone (Viibryd).
You had many symptoms of
serotonin syndrome. Serotonin syn-
drome may consist of mood changes
such as anxiety and restlessness, but
a person may develop confusion and
disorientation. Abnormalities of the
muscles, such as rigidity and the
uncontrollable jerking you mention,
are very common. Finally, sweating,
high body temperature, vomiting
and diarrhea also may be part of the
syndrome.
Treatment is stopping the medi-
cation that caused the symptoms.
Many experienced practitioners will
use the same or similar medications
that caused the serotonin syndrome
at a lower dose if it is the only
effective treatment, but this requires
expertise and careful monitoring.
Deplin, a brand of methylfolate,
is a B-type vitamin that can make
SSRIs work better. It’s not associ-
ated with serotonin syndrome, as far
as I have been able to fi nd.
DEAR DR. ROACH: A diagnosis
of “Cameron erosions of the esopha-
gus” was made after my gastrosco-
py. I was not able to fi nd that term at
nlm.nih.gov/medlineplus. Have you
ever heard of this? -- A.M.
ANSWER: To be honest, no.
However, I did look it up, and found
that Cameron erosions are found
only in people with a hiatal hernia.
A hiatal hernia isn’t like an umbili-
cal or groin hernia; in a hiatal her-
nia, the stomach goes upward into
the chest through the diaphragm,
the sheet of muscle that separates
your chest from your abdomen. It
is our primary muscle for breathing.
There normally is a hole in the dia-
phragm (the hiatus), but in a hiatal
hernia, the structures that hold the
stomach in place weaken and allow
it to go into the chest. The part
of the stomach inside the chest is
prone to bleeding, and the areas that
bleed can be seen by the endoscope
and are called Cameron erosions, or
ulcers.
Small hiatal hernias usually can
be managed with medication as nec-
essary. However, large hernias and
those with a history of bleeding may
require surgical repair. An expert is
needed to decide whether surgery is
required.
obligations unresolved, or you might
fi nd yourself tripping over all those
loose ends later on. A relative has
important news.
LEO (July 23 to August 22) Expect
a challenge to the usual way you do
things. Although you might prefer the
tried-and-true, once you take a good
look at this new idea, you might feel
more receptive to it.
VIRGO (August 23 to September
22) Much work has yet to be done to
polish a still-rough idea into some-
thing with signifi cant potential. Expect
to encounter some initial rejection, but
stay with it nonetheless.
LIBRA (September 23 to October
22) Th ere still might be some commu-
nication problems in the workplace,
but they should be resolved soon.
Meanwhile, that “tip” from a friend
should be checked out.
SCORPIO (October 23 to November
21) A new relationship appears to need
more from you than you might be
willing to give right now. Best advice:
Resist making promises you might not
be able to keep.
SAGITTARIUS (November 22 to
December 21) Th at restless feeling
encourages you to gallop off into a new
venture. But remember to keep hold of
the reins so you can switch paths when
necessary.
CAPRICORN (December 22 to
January 19) A demanding work sched-
ule keeps the high-spirited Goat from
kicking up his or her heels. But play-
time beckons by the week’s end. Have
fun. You earned it.
AQUARIUS (January 20 to
February 18) You’re beginning to
come out from under those heavy
responsibilities you took on. Use this
freed-up time to enjoy some much-
deserved fun with people close to you.
PISCES (February 19 to March 20)
Before you get swept away by a tidal
wave of confl icting priorities, take time
to come up for air, and reassess the
situation. You might be surprised by
what you’ll fi nd.
Siuslaw N ews
!
AD IT DAY
E
R
TO
www. the siuslawnews.com
E -E DITION
• S PORTS • T OP S TORIES • O BITUARIES • W EATHER • F ORUMS • B LOGS