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Dr. Andrew Rynne

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Would signs of serotonin syndrome recur after resuming Lexapro?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 106 Questions

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Posted on Wed, 22 Aug 2018 in Men's Health
Question: after being on 10MG of Lexapro for a few days i had an episode of what may have been serotonin syndrome. I had also recently started taking Yaz. I hadn't eaten or drank much that day. In the middle of the night( I wasn't asleep) I suddenly felt that I was burning up from inside. It was extremely intense and physical. I also smelled an odor that wasn't there. The symptoms only lasted a few minutes. I didn't have a fever. My usually low BP was 134/96 at the ER They diagnosed a panic attack/stress reaction. I am under a lot of stress but am not prone to panic attacks.
The ER said to stop the Lexapro which I did. My question is if I restart 10MG of Lexapro and it was serotonin syndrome, will it recur?
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Answered by Dr. Bonnie Berger-Durnbaugh 2 hours later
Brief Answer:
Information.

Detailed Answer:

Hello,

I have reviewed your query and here is my advice.

I recommend discussing this with the doctor who is prescribing the Lexapro, but I also recommend restarting the Lexapro at a fraction of the dose and going up on it slowly. It will take longer for it to reach a level that is therapeutic this way, but you will have a better idea of what is going on. You will also get through most of the the starting side effects more easily or not feel them at all.

It does sound like the symptoms you had were more likely due to panic attack but I can't say with 100 percent certainty. In answer to your question though, it is unlikely to happen at a very low dose of Lexapro.

You can ask your doctor to prescribe 5 mg and start with 1/2 of that for 1 week, then go up to 5 mg. In another week, 7.5 mg. And then if tolerating it well, 10 mg. Also, some people who are sensitive to medications can get benefit from lower than standard therapeutic dosage so it may turn out you don't need a full 10 mg if you have a history of medication sensitivity and using lower dosages.

I looked up the combination of Lexapro and Yaz on Lexicomp drug database to see if one potentiates the other and there are no interactions. So Yaz would not be causing the Lexapro dose to be higher than expected.

Take care.

Dr. Bonnie Berger-Durnbaugh, General & Family Physician
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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