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Dizziness, fast heart beat, low BP. Taking prednisone, methotrexate. Serotonin Syndrome?

My husband recently experienced some extreme dizziness a fast heartbeat(123) and his blood pressure was fairly low. I reviewed his medications and he is taking 25mg of amitriptyline , and 50mgs of Tramadol HCL. He also takes Prednisone amd methotrexate 2.5 mg 7 tablets. I was worried he might have Serotonin Syndrome . I was concerned about the tramadol and amitriptyline.
Asked On : Mon, 20 Aug 2012
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Ayurveda Specialist 's  Response
1. Amitriptyline is TCA [tricyclic antidepressant] and tramadol is [opioid analgesic], and going through their therapeutic profile:
. Increased risk of seizures are there if both are used simultaneously.
. Increased risk of Serotonin syndrome is more with SSRI (selective serotonin reuptake inhibitors) or MAOIs (mono amine oxidase inhibitors)

2. ADR [adverse drug reaction] of both drugs when taken together or as single are: postural hypotension, dizziness, tachycardia,palpitations, [symptoms in your history]

3. There is no laboratory test for serotonin syndrome. Therefore diagnosis is by symptom observation and investigation of the patient's history, check with your Attending doctor, seek immediate medical attention.
Answered: Mon, 20 Aug 2012
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