First off whey protein and SSRI's are safe. Whey protein and irrervsable MAOI's are not, they can cause hypertension.
You can assume that since they are neither warnings on the incert slip about SSRI's and cummin (however you spell it) and its not forbiden on an MAOI diet that it is perfectly safe. It may be an MAOI but a very very very very weak one.
You didn't describe any of the symptoms of mild Serotonin syndrome: high temp 39C, myoclonus (typically of the lower body), dialated puples, mild agitiation with cognition mostly intact or hypomania, headache, severe sweating, halluncinations, tachycardia 120+ and uncontrolable shivering. Furthermore symptoms would have developed much quicker appering within 3-6 hours.
Serotonin syndrome in people taking a full dose of escitlopram (10-20mg) is about 1:5000-1:10000. In these cases it often takes up to a week for full blown symptoms to emerge. Its not uncommon for people to take small overdoses of up to 100mg without experiencing any or many symptoms of serotonin syndrome. Life threating overdoses with SSRI's alone are almost impossible, simply due to the amount of pills that have to be swallowed. Even patients treated with the MAOI Phenalzine and Fluoxetine (prozac an SSRI) not all present with any detectable serotonin syndrome and those that had mild symptoms. Phenalzine and Tranlycpromine are often used together with Lithium (potentiates serotonin) and of 3 or 4 studies I have read no one presented with serotonin syndrome.
What you did describe perfectly was a panic attack. Feelings of impending doom (can be non-spesific, fear of attack or as in your case fear of a severe medical problem), feeling agitated and scared, with rasing thoughts. Heart rate often increases and some mild sweating is common. Feeling very hot or cold and hyperventilation (breathing to fast), feelings of being smothered of unable to breath, nausa, abdominal discomfort (sometimes severe enough to make them be sick), numbness, feeling dizzy, lightheaded and as if you are going to pass out (if hyperventilation is prolonged and severe people sometimes very briefly pass out as this forceably reduces breathing rate) and palpatations. Obviously you didn't mention even half of these and not all apply to each person but I feel the symptoms you did mention fit better and the statistically the chance of serotonin syndrome at 2.5ish mg (not to mention no serotonin syndrome from citalopram at 20mg) is about a 100-1000 times less likely than a panic attack.
The best short term way to deal with a panic attack is first to do the last thing you want to - slow your breathing, taking deep, slow breaths. Once you have achieved that it is best to distract yourself for ten mins or so doing something you find enjoyable. By which time you will likely find yourself feeling fine, or at least a lot less jittery.
I hope the information about the rareness of serotonin syndrome goes some way to reducing your fear you might experience it.
By the way Phoenicis hypertension isn't seen in serotonin syndrome unless the toxicity is moderate-severe, mostly because the tachycardia isn't fast enough and the excess sertonin needed to cause a massive release of cortisol and adrenaline is quite significant.
Edited by Tom_, 19 May 2014 - 05:02 PM.
