Hi guys, I've been reading this forum for a year or so. Great stuff and very impressed by all the knowledgable contributers.
I was wondering if anyone could help me. Basically, I've suffered from anxiety and OCD for three years or so after dabbling with meth and E recreationally in 2008 - I only used them a few times in a period of 6 months but it seems to have been enough to trigger my current condition. Anway, the last time I used E (one pill: it might not've been MDMA actually, might've just been speed or even meth, hard to say), I had the most terrible comedown. Almost in tears daily for a week or so after, tearing myself apart etc - and I've been plagued with obsessive and negative thoughts ever since - I'd started to get social anxiety about three months before that but with no effects on general mood etc. (I should also make clear I've not used recreational drugs since then and never will again.)
Anyway, from that point until now I've tried various supplements generally recommended for anxiety/OCD, to no great effect. One strange thing is that I've had very severe reactions to anything that raises serotonin levels, a single capsule of 5-HTP, Red Ginseng and Rhodiola will cause my face to flush, my face will start itching, I'll feel washed out and irritated. The most severe reaction like this I had (until now) was from Fluoxetine (Prozac), took it for three days at 20mg and by the second day I was feeling awful, feeling very hot - feverish, couldn't get out of bed, itching all over, dilated pupils, anxiety & irritating, strung-out feeling, face bright red, and so on. I've also had exactly the same reaction after taking St John's Wort* for a week or so (had this twice, once in 2008 then not realizing why I'd reacted badly to it, tried it again in 2009, same awful result).
I took the Prozac in early 2010 and haven't been to the GP again regards these conditions until I went earlier today. But recently I've had the very same reaction I describe above to the antibiotic Doxycycline, took it for a couple of days at the normal dose and was ill for four days after, same feelings and symptoms I had when taking the serotonergics. The experience of these ill-effects is qualitatively very distinct btw, the effect I got from taking Doxycycline is not just descriptively similar to the effects I got after taking Prozac, it felt qualitatively absolutely the same. This was interesting to me since I thought I was experiencing a mild form of serotonin syndrome, but I don't think Doxycycline is serotonergic at all??? And then, just last Sunday/Monday, I took doses of Piracetam, 1600mg both days, and I've been feeling ill since then with exactly the same symptoms!
Does anyone know what's going on? I still think it's something to do with serotonin - it matches the symptoms of mild serotonin syndrome and until the piracetam/doxycycline I'd only experienced this reaction specifically from serotonergic supplements.
Anyway, it occured to me that the reason for my anxiety/OCD might not be lack of sensitivity to serotonin, but the opposite. I'm a total layman when it comes to neuropharmacology (hadn't even heard of most of this stuff before I came across this board by chance a year or so ago), but could my reaction to serotonin (if that is indeed what's causing these ill-effects) and my condition be related to oversensitive/reactive 5-HT2 receptors?
Today I'm still feeling slightly ill, with malaise, fevered feeling and itching - better than before - but it's already a week since I took the Piracetam that triggered this. So anyway, I went to the GP this morning with the idea in mind that I'd ask for something that could cause 5-HT2 receptor downregulation without increasing serotonin in the body/brain and causing the aforementioned symptoms. After a bit of arguing, I got him to prescribe me Mirtazapine. Incidentally, he wanted to prescribe me Citalopram, saying that Mirtazapine was 'worse' and that there's no reason to think that I wouldn't have the same effects from Mirt as I had from Fluoxetine etc. But as far as I know, he's wrong, or at least Mirtazapine is the anti-depressant least likely to cause Serotonin Syndrome of practically all of them?
However, in case he's right (because there are a couple of studies which show Mirtazapine causing SS) I'll wait until I feel completely better before taking it. The hope is that Mirt will deal with my OCD/anxiety outright. But if it doesn't, there's hope that it will make me less sensitive to serotonin so that I could add an SSRI in future, am I on the right track? I know this is all a bit vague, but if anyone can shed any light I'd be most grateful.
*I should also mention I used to take St John's Wort daily a couple of years before I first had these problems to no ill effect (can't say it did anything positive either, but I had no mood problems then), also used to take same red/panax Ginseng with no problems. So presumably something at some point changed, resulting in anxiety/OCD and a bad reaction to seroternegics?
Edited by Emptyset, 03 October 2011 - 02:22 PM.