This is topic Metronidazole and antidepressant drug induced serotonin syndrome in forum Medical Questions at LymeNet Flash.

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Posted by Marrit (Member # 25454) on :
I don't know if anyone else has posted this, so I'm going to post it. For those on SSRI or SNRI's and Flagyl please watch for this:

Potentially fatal serotonin syndrome

It is important to note that Serotonin Syndrome is not fully understood. The complex drug interaction can happen after a couple days or take up to months. The exact mechanism is not known, a theory of serotonin dysfunction helps explain how the syndrome presents and how it is to be treated. Signs and symptoms are muscle rigidity, headache, elevated blood pressure, and changes in blood chemistry. The only direct treatment is to discontinue the offending drugs. Recently, there have been reported cases of SSRI/SNRI antidepressant drugs and metronidazole induced serotonin syndrome,[19][21] this information is not included on the metronidazole patient information leaflet. SSRI and SNRI antidepressants include Prozac, Lexapro, Celexa, Zoloft, Effexor, Cymbalta, etc.
Posted by steven (Member # 13101) on :
i have insomnia (and more) since being on tini and flagyl. maybe serotonin is the reason. a dangerous drug.
Posted by bcb1200 (Member # 25745) on :
I'm on 20 mg Prozac and plan on coming off (went on before my lyme DX because all the docs said I had "stress" and was "depressed.")

I've been pulsing flagyl for 3 days every 2 weeks since May. So far no problems...knock on wood. Thanks for the info!
Posted by cleo (Member # 6646) on :
Lyme and other chronic infections lower serotonin levels. When you kill alot of lyme with the flagyl you free up more serotonin soooo if you are also taking an ssri to increase serotonin along with flagyl you are flooded with too much serotonin.
Makes sense to me.
Posted by Marrit (Member # 25454) on :
steven, I'm so sorry to hear that you're suffering the effects of tini and flagyl. It took a month for me to get rid of the picking feet, which was the last symptom to resolve after only a few days of flagyl. I wonder if a B-12 shot would help?

bcb1200, You're welcome. Never hurts to be informed.

cleo, That's an interesting theory.
I've read that somewhere between 80-95% of our serotonin is in the gut, and Lyme allegedly loves the gut. Also that people with IBS symptoms who are diarrhea prone tend to have too much serotonin, and people who are constipation prone have too little ...

Re diarrhea, a serotonin article on wiki states, "Serotonin is produced by pathogenic amoebas, and its effect on the gut causes diarrhea."

If true, an amoeba infection could add to the serotonin burden in addition to flagyl and anti-depressants.

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