OpenHealth Q&A

Get answered by medical professionals

A Mistake I Made Regarding Serotonin Syndrome (19F)

7/26/2025, 4:50:22 PMMale25-34

I recently discontinued my 10mg dose of fluoxetine about two weeks ago. Not realizing the prolonged duration of the medication's effects in the system, I took 500mg of bromelain last night. Shortly after, I began experiencing some concerning symptoms, including an elevated temperature and an increased heart rate—peaking at 70 bpm, which is much higher than my normal rate of 40 bpm. These symptoms have somewhat intensified. Should I consider going to the emergency room for what seems to be a mild case of serotonin syndrome? Is there a possibility that my condition might deteriorate further?

Drug AllergiesHivesAllergy & Immunology

Answers (1)

Cony

7/26/2025, 4:50:41 PM

OpenHealth AI

It sounds like you're understandably concerned about your recent symptoms after stopping fluoxetine and taking bromelain. You're right to be cautious, as serotonin syndrome is a serious condition, but let's clarify a few points and outline some steps for you.

Main Points:

  1. Possible serotonin syndrome symptoms: Elevated temperature and increased heart rate can be concerning, particularly after changes to your medication regimen.
  2. Monitoring is key: Your symptoms should be taken seriously, especially since they have intensified.
  3. Emergency care: If your symptoms worsen, seeking immediate medical attention is crucial.

Explanation:

Serotonin syndrome can occur when there is an excess of serotonin in the brain, usually triggered by certain medications. Fluoxetine stays in your system for a while, and mixing it with other substances like bromelain could potentially lead to interactions.

The symptoms you've described—elevated temperature (fever) and an increased heart rate above normal—are consistent with serotonin syndrome, although elevated heart rates can also stem from various other causes. Your resting heart rate of 40 bpm is significantly lower than average, which could complicate your response to any changes in medication.

Next Steps:

  1. Monitor Symptoms Closely: Keep an eye on your temperature, heart rate, and any additional symptoms like restlessness, confusion, excessive sweating, or muscle rigidity.
  2. Stay Hydrated: Drink plenty of fluids to help your body manage any potential effects.
  3. Rest and Avoid Stimulants: Give your body time to recover, and avoid caffeine or other stimulants that could elevate your heart rate further.
  4. Emergency Care: If you experience severe symptoms (higher fever, severe heart rate increase beyond what you've reported, or if you feel very unwell overall), do not hesitate—go to the emergency room.

It’s always better to err on the side of caution when it comes to your health. Please keep monitoring yourself, and if things feel off, seek medical help promptly. Take care of yourself, and let me know how you’re doing.

Related Questions

Concerns About Post-Surgery Rash

I am a 29-year-old female and I have been prescribed prednisone to manage an allergic reaction caused by surgical adhesive. Is it typical for prednisone to exacerbate itching associated with the rash? I have observed that it is gradually improving, but the itchiness has intensified. Additionally, I experienced excruciating leg cramps last night, preventing me from falling asleep until 5 AM. I consulted a doctor virtually for my prescription, which means I can’t inquire about these side effects with the prescribing physician without incurring another $30 copay.

Skin AllergiesDrug AllergiesAllergy & Immunology
Male25-34
16 minutes ago

Concerns About Enlarged Spleen - Seeking Insight

Profile: 38-Year-Old Male, Height: 6'0" Health Background: No smoking or drug use. Account for anonymity. Last Friday, I underwent a liver ultrasound that included a full-body scan. It turns out my spleen is measuring 24cm, which I've discovered can be quite concerning. Interestingly, I currently have no noticeable symptoms such as pain or discomfort. The liver assessment was prompted by my drinking habits and a recommendation from my psychiatrist. The results for my liver indicated: 1. "UNREMARKABLE SONOGRAPHIC APPEARANCE OF THE LIVER" 2. NORMAL MORPHOLOGY AND PARENCHYMAL ECHOGENICITY, with a note on "MILD LIVER HEPATITIS HEPATOTOXICITY". I have been experiencing fatigue and occasional dizziness, which I attributed to possible dehydration. Additionally, I struggle with depression and anxiety and am currently prescribed Lexapro at a dosage of 10mg. Returning to my spleen situation, I can’t help but feel anxious about its enlarged size. Back in March, I had some blood tests that raised some concerns for my psychiatrist, which I will share shortly. I wonder if this enlargement indicates an infection, cancer, or is still linked to my liver condition. My alcohol consumption tends to be low, mainly social or just a couple of light beers after work—if that could mean anything. I’m not sure why I'm posting here, but I'm worried since my psychiatrist is often difficult to contact. My next appointment with my primary care doctor isn’t until January, which feels like a long wait. Part of me is tempted to go to the ER, but I also recognize that searching online can lead to unnecessary panic. I’ve reached out to my doctor and hope to hear back by Monday. In the meantime, any suggestions or insights to alleviate my worries would be greatly appreciated—I'm open to any potential news, even if it’s not the best. Attached: Blood test results from March (links removed).

Drug AllergiesAsthmaAllergy & Immunology
Male25-34
1 hour ago

Understanding the Risks of Paracetamol Overdose

A hypothetical scenario poses a troubling question: If a 20-year-old female, weighing 47kg and standing 160cm tall, ingests either 45 or 23 grams of paracetamol without seeking medical assistance, what would be the potential outcome? How long might she survive under these circumstances while merely appearing to be unwell to family members in order to evade hospitalization? Furthermore, is there a substantial risk that she could succumb to the effects during her sleep? Paracetamol overdose is a serious matter, with significant health implications. It is crucial to understand that taking such high doses can lead to severe liver damage, potentially causing life-threatening scenarios. Without prompt medical intervention, the prognosis can worsen as symptoms may not manifest immediately. Vigilance regarding signs of overdose is essential; if someone seems to be in distress, it is vital to prioritize medical care. Individuals may not be aware of how serious the situation can become, particularly when hiding the extent of sickness from those closest to them. Therefore, it's of utmost importance to encourage open communication about health issues rather than concealing symptoms that could lead to dire consequences.

Skin AllergiesDrug AllergiesAllergy & Immunology
Male25-34
1 hour ago

Insect Bite Concerns: Should I Seek Medical Attention?

Earlier today, while I was dirt biking around 2 pm CST, I suddenly experienced a sharp sensation in my arm, akin to what one might feel after a bee sting. Upon inspection, I noted a tiny red dot at the center of a slightly raised white area that measured about an eighth of an inch. I paused my ride to apply some Neosporin and took ibuprofen, though the stinging persisted throughout my outing, which concluded around 7:30 pm. It feels somewhat improved now, likely due to the ibuprofen's effects. However, I've noticed that the area has since developed into a larger red ring, which raises my concern. Though I’m not in the typical habitat of a brown recluse spider, it’s a possibility that worries me at the moment. Additionally, as far as I know, I do not have any allergies to bee stings. I'm looking for any insights or recommendations on what steps I should take next. Thank you!

Hay FeverSkin AllergiesHives
Male25-34
3 hours ago

Concerned About Diaper Rash?

For the past week, my 13-month-old son, who weighs 23 pounds, has been dealing with a persistent rash. Despite using Aquaphor and Triple Paste, we haven't observed any improvement. The irritation is localized in his groin and pubic region. Any advice would be appreciated!

Skin AllergiesAllergy & ImmunologyDermatology
Male25-34
4 hours ago