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A greater awareness of the combinations that trigger the syndrome could lead
to prevention, but a diagnostic challenge exists due to the fact that the
list not only includes prescription drugs, but also over-the-counter
medications and herbal supplements. The following are some of the products
known to be associated with serotonin syndrome: Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Selective serotonin reuptake inhibitors (Zoloft, Prozac, Paxil, Lexapro, Celexa) Venlafaxine (Effexor) Trazodone (Desyrel) Nefazodone (Serzone) Meperidine (Demerol) Dextromethorphan (Cold Remedies) Chlorpheniramine Sumatriptan (Imitrex) Atypical antipsychotic (Zyprexa, Risperdal, Seroquel) L-dopa Meridia Lithium Valproic acid (Depakene) Linezolid (Zyvox) St John's Wort Ginkgo Biloba Many experts blame the rise in cases of serotonin syndrome on the fact that so many different drugs are being prescribed to patients at the same time in combinations, or "drug cocktails," which have never been approved as safe and effective by the FDA for any use and without considering the over-the-counter medications that patients may be taking. The syndrome has become more prevalent in children as the off-label use of drug cocktails with children has increased. Some experts suspect serotonin syndrome in the death of 4-year-old, Rebecca Riley in Massachusetts, on December 13, 2006. Critics say the Riley case highlights the need to put an end to the rampant off-label prescribing of adult psychiatric drugs to children. "The general public is unaware that almost no psychiatric drugs have ever truly been tested for children," according to David Oaks, director of MindFreedom, an international human rights organization. "All psychiatric drugging of children," he says, "is essentially 'off label' in the sense that doctors have an enormous range of discretion when prescribing psychiatric drugs to young people." "It's time for society to get hands-on with the mental health system," Mr Oaks warns, "and rein in the immense tyrannical power that doctors now have."
The State Police
investigator's report in this case said psychiatrist Dr Kayoko Kifuji, at
the Tufts-New
England
Medical Center, prescribed 3 medications for Rebecca: 750 milligrams a day
of Depakote; 200 milligrams a day of Seroquel; and .35 milligrams a day of
clonidine. A state trooper's affidavit said a Walgreen's pharmacy filled a number of
clonidine prescriptions for the Riley's when they should have had an ample
supply and that several times, Dr Kifuji approved extra pills because
Carolyn Riley said she had run out or lost her supply. Doctors Fail to Recognize Life-Threatening Serotonin Syndrome - 2 - 2 - 3 - 4Seroctin 375 mg per capsule with 120 capsules per bottle. $24.99 Bottle + $5.00 shipping Seroctin is the natural serotonin optimizer. Order
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