Serotonin Syndrome

[emma1]

Does anyone know what supplements affect serotonin? I know that St. John's Wort, Inositol, and 5HTP all affect serotonin, but what about SAMe. I went to a new doctor today, and he suggested trying up to 4 grams of inositol for my daughter's OCD symptoms. He specifically told me not to use 5HTP, but said it was OK (he thought) to continue with the 400 mg of SAMe. However, as I was searching the internet for more info on inositol and serotonin, I came across an article that said SAMe could also raise serotonin.

[Chemar]

Hi Emma

the supplements that help with OCD all raise serotonin. that is why they work

 

samE works becasue methionine also raises serotonin

 

however, serotonin has to be elevated way above normal for "serotonin syndrome spiking" to occur. As I have mentioned to you in PM and posts, one really should have doctor supervision when using more than one of these supps so as to modulate their combination with care

 

as your daughter responded well before to high levels of Inositol it may be worthwhile for you to follow the doc's advise and try her on just that and remove the other serotonin stimulating supps for a while

 

did your doc give a reason for saying to avoid 5HTP? of all the serotonin boosting supps it is the one that has the biggest chance of side effects, which is why many people prefer using tryptophan

[faith]

Emma,

what are usung presently to help with your dd's ocd symptoms? Is anything helping so far, or are you still fine tuning it?

 

also, could I ask if you have looked into any behavioral therapy for the ocd? Is any of this impacting her schoolwork? I think I am having to look into some behavioral therapy for the ocd and perfectionism tendencies that my son is having that seems to be the cause of his not finishing anything timely in school. The school has suggested this and I don't know where to begin. If you have looked into this, or anyone else here is doing that, I'd appreciate any advice. I've not used any supps for ocd, since am still working on the tics.

 

Faith

[emma1]

The doctor I consulted was a psychiatrist who initially was pressing for an SSRI, which I didn't want to try until I had determined the natural approach wouldn't work, which I haven't determined yet.

 

I had told him our history with inositol, SAMe and 5HTP. I told him that we had tried a little over 2 grams of inositol and felt there was some improvement, but that it didn't handle the entire issue. He had information about inositol (at least he knew about a study with it using 18 grams). He said he did not believe most would need that 18 gram level, but suggested that "if I was not going the Paxil route" he would suggest using inositol. He has not had anyone else try it. He said he would suggest using 4 grams, and he said it would take at least 6 weeks to see if it is working.

 

I told him that (at 2 grams) inositol hadn't really worked alone, which is why we started SAMe. I told him that I felt that the SAMe kept my daughter upbeat -- basically she still had some obsessive thoughts, but they didn't get her down. She was able to go on, and have a reasonably happy life, even though she was still having some of the ocd. So, he said, he didn't want to mess with that. He said he thought that SAMe was used more for depression (and then we had a huge discussion about whether my daughter was "clinically depressed" -- I basically said that when the ocd was overwhelming, she was pretty unhappy -- but lately the ocd was disturbing, but not totally consuming her). He said he thought he remembered a study that had used SSRIs and inositol, so he said he thought it would be OK to keep the SAMe. (It was clear he was more versed in SSRIs than the natural supplements though -- so, I am still a little hesitant. He said the SAMe wouldn't help with the ocd. (But I find her overall simply happier and better able to handle life with it -- so I really hate to stop it. But, I would like to see the ocd recede a little more too. . .)

 

So, by the time I got to the 5HTP, he had already agreed to the inositol and SAMe, and I think he just didn't want to add anything else, especially since I hadn't seen marked improvement with 5HTP. I haven't found someone yet, like you did Cheri, who can speak in depth to the supplements and come up with a combo program. I mean -- I was the one who mentioned both the inositol and the SAMe!

 

We have tried CBT -- at least that is what the clinical therapist says she is doing. I thought there would be more discussion of exactly how to deal with the negative thoughts. . . I cannot say it isn't helping, but I am concerned that it seems like it could just go on and on and on, and it is pricey. Part of the issue might be that my daughter does *not* really want to discuss her thoughts with the therapist. Mostly, it seems the therapist is telling my daughter not to be so hard on herself, that everyone has negative thoughts sometimes, that these thoughts don't make her a bad person, etc.

 

During times of anxiety, the ocd is worse. I do believe it has affected her studies (she is at a very competitive high school), but she is insistent that I tell no one at the school (I had tried saying something earlier and it *did* backfire), so. . .

[Chemar]

Emma

I sure understand your frustration

 

it honestly wasnt till we had the full combo of supps that we got the breakthru out of the endless cycle of OCD, anxiety, depression, frustration etc that my son was in and I really did feel the 5HTP and methionine worked best for him

 

as mentioned before tho he did eventually find it was making him edgy so stopped it as well as the SJW as he doesnt seem to have much depression anymore. He now only uses inositol and methionine and all seems pretty stable, although we have come to understand some of the OCD etc is always mildly there as part of his TS spectrum, but it no longer interferes with his life and he really has learned excellent coping skills

 

I am not sure your therapist is helping your daughter...talking and working out coping mechanisms should be bringing her release, not more anxiety so you may want to let her take a break there or look for a different therapist. My son learned much from a just few sessions and has not had any need to return

[emma1]

Cheri, I especially hate to give up on the SAMe. It doesn't really take away the problem (the OCD), but it does certainly seem to make the problem less of a problem (that is, less troubling to her). If that makes any sense at all!

[Chemar]

yes it sure does make sense....my son feels that way about his methionine too as he knows it takes the edge off the OCD for him

[emma1]

Does anyone know exactly what serotonin syndrome looks like? Is it something obvious, or is it subtle? Someone mentioned a "change in mood." I have a teen girl, so we had changes in mood daily, even before all this started!

[Chemar]

Hi Emma

 

nope there is no confusing a serotonin spike for a mood change!! it is pretty dramatic reaction to excessive serotonin

 

here is the Wiki info (scroll down for symptoms)

http://en.wikipedia.org/wiki/Serotonin_syndrome

 

and here is the info on USPharmacist

http://www.uspharmacist.com/oldformat.asp?...eat/acf2fa6.htm

 

it usually occurs when taking meds that elevate serotonin and then adding either more meds or herbs/supps that spike it

 

 

 

ps interesting to see wiki mentions boswellia as my son takes a boswellin/curcumin combo for crohn's as an antiinflammatory so it is likely helping his OCD too