**TW: Tachycardia, Serotonin Syndrome symptoms, descriptions of panic attacks w/ hyperventilation,**   


In February I was prescribed Focalin Extended Release for my ADHD, my psychiatrist had me increasing by 5mg every four days until I found a good dosage. Prior to this, I never had any issues with GAD, though I did have a freak event in 2019 that I will mention later. At 15mg I found that the Focalin caused me anxiety, so I dropped back to 10mg, where I felt comfortable.  
A couple weeks later I had a major anxiety attack and ended up in the ER because I wrongly believed I was having a heart attack (I had almost no experience with anxiety up to this point).  
I sat on a gurney in an overflow hallway for three hours, had an EKG, got told it was anxiety, and was promptly sent home.  


After this I stopped taking my ADHD stimulants (even though my psychiatrist told me to keep taking them, which was a red flag to me), and was prescribed 20mg Prozac and 25mg Vistaril ("take as needed up to 3 times a day") for my anxiety. On day 1 I just took the Vistaril and an hour or two later I felt massively productive, having ideas and doing stuff I hadn't done in almost a year. The next day I started my prozac and didn't feel much more of an improvement, but I did feel slightly more energetic and productive during the earlier half of the day. The boost in productivity from the Vistaril and the Prozac lasted me about one week at a downward taper, at which point I no longer felt any of the previous benefits. In fact, although my attacks were happening less often, my anxiety became daily and would sometimes last for hours.

Fast forward another week and my anxiety had become constant, with the amount of time during the day that I felt normal being less than the amount of time that I felt anxious. My anxiety attacks became much more frequent, so I began taking the Vistaril more (only ever up to 3 separate times in a day, no closer together than 4 hours). I developed an anxious tick of scratching/rubbing my left pectoral muscle and side, largely due to the raging heartbeat and the persistent fear that I might be having heart problems (even though I had been proven contrary on ER and Urgent Care visits in the past). I also noticed that I began clenching my jaw very often without any intention to, as if it were doing it on its own.

Now we come to this previous monday. I got into a minor spat with a friend over text and felt my anxiety flaring up at 7pm, so I took one Vistaril and began square breathing to calm myself. Initially I began to feel my anxiety ease, but as the Vistaril entered my system my heart began to race and my anxiety peaked.  
I knew 30 minutes should have been enough to begin calming down from the Vistaril, but instead I was having another attack, this time experiencing tachycardia, and could feel my pinky and index fingers tingling on both hands. I called 911 at 7:30, and had three more panic attacks back-to-back while waiting on the ambulance. They arrived around 7:45 and checked my vitals, my blood pressure was through the roof and my BPM was 150. Getting shot with saline in the ambulance was a very bizarre experience, it made me feel heavy and confused.  
Once at the hospital, the doctors ran blood tests and determined my heart enzymes were fine and that I was mildly deficient on potassium, but nothing else. After sitting for a few hours the doctor came to see me, gave me Ativan and potassium, and told me to call my psychiatrist and change my medications as soon as their office opened, and sent me home around 2am.

It turns out that I had developed serotonin syndrome, which is why the Ativan made me feel more calm and normal than the Vistaril ever has since I began taking it. I had been experiencing mild SS symptoms for around a week prior, and constantly increasing anxiety for around two weeks before that.  
Last night (Tuesday) I still was unaware that it was SS and took my Vistaril again in the evening around 8:30. I began to feel drowsy but I couldn't fall asleep for over an hour of just laying in darkness with my eyes closed. I woke up five times throughout the night. Turning on the bathroom lights nearly blinded me, and my vision was almost completely white for about 30 seconds. I quickly realized that my pupils were **massively** dilated, and the diarrhea I'd been experiencing for the last few days came back. Turns out that the only symptoms on the non-life-threatening list that I *hadn't* experienced were goosebumps and tremors.  


I also experienced tachycardia after taking my meds in 2019 (a low dose of Zoloft I had been on for about two months for depression). At the time I had no issues with anxiety beyond large crowds exclusively. On my commute to work one morning I began hyperventilating on the interstate and my body began to crumple up and go numb. I pulled over and typed 911 with a compressed hand and the EMTs arrived just in time to calm me down enough to keep me from passing out. I also had issues with unintentional jaw clenching for a week or so before this. That now seems to be sort of a tell for me, I guess.  
I never got an explanation for what caused it beyond "you had a panic attack and your heart couldn't distribute enough oxygen while hyperventilating." I never had that problem again because I stopped taking my zoloft immediately.  
Unfortunately it took me repeating that event earlier this week to finally understand the cause.

&amp;#x200B;

I've stopped all medication and I'm changing psychiatrists immediately, as mine has given me multiple red flags already, and it often feels like she's treating me as if I am a junkie looking for a fix. Getting Ativan in the ER is the first time I have ever taken a prescription sedative in my life. Excluding the Zoloft I have never taken prescription-anything for mental health or ADHD until this psychiatrist.  
This is particularly frustrating to me because she knowingly prescribed me three medications that impact serotonin, two of which are often recommended against being taken together (ADHD stimulants and Prozac), ***while fully aware*** that I had a **major** reaction to a notably low dose of Zoloft a couple years ago without being on any other medications, the symptoms and condition of which I described to her in clear detail.  
I'm working to see a new psychiatrist and we will be operating under the concept that my anxiety is due to an *overactive* serotonin system, **not** an underactive one.  


**If you begin having issues with medications that impact serotonin, be cautious.** Serotonin Syndrome can become life threatening in a very short timespan. I'm very thankful that my symptoms during that major event were not as bad as the symptoms other people have experienced, but it was absolutely the scariest moment of my entire life, and as best as they tried to hide it for my anxiety's sake, I could tell that even the EMTs were concerned. I was on very low doses compared to other people who take similar medications and this still happened to me.

People, please please please be careful. Research the interactions of the medication you are prescribed, and be willing to question your doctor if they say or prescribe something that doesn't sit right with you.