Serotonin Syndrome
Serotonin syndrome is a potentially deadly condition that can occur after using some stimulant drugs- particularly MDMA.
Some signs and symptoms include (but are not exclusive or limited to) -
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Agitation or restlessness
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Confusion
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Rapid heart rate and high blood pressure
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Dilated pupils
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Loss of muscle coordination or twitching muscles
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Muscle rigidity (stiffness)
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Heavy sweating- a very important sign, even on hot days
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Diarrhea
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Headache
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Shivering
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Goosebumps
Severe serotonin syndrome can be life-threatening. Severe signs and symptoms include:
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High fever
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Seizures
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Irregular heartbeat
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Unconsciousness
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You should immediately seek medical attention for anyone with the above symptoms
Caring for someone under the influence of a stimulant
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Encourage them to seek the help of a crowd care service or medical service
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Find out what the person has had, how much, and when the last dose was taken
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Reassure the person if there are signs of anxiety such as irritability, speeding and/or confused thoughts, agitation, visible discomfort or fear and then seek help in these situations as these can be signs of cognitive distress
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Watch for signs of significant toxicity: drop-in consciousness, change in consciousness (confusion), paranoia, Shortness of breath fever
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Remain calm, patient, and supportive by talking to them and helping them to take a rest
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Avoid hostile or aggressive tone and/or stance
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Encourage them to sip water – monitor, how much they consume
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A guide is to consume 250ml an hour whilst resting, and 500ml an hour whilst exercising (including dancing!) as a safe maximum
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Do not douse them in water
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Signs of stimulant overdose
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If in doubt at any time do not hesitate to seek medical attention.
Additional signs to escalate your response to medical may include:
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Severe anxiety or fearfulness
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Delusions (seeing or hearing things that aren’t there)
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Racing pulse
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Profuse sweating and body chills
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Excessive thirst
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Breathing difficulties
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Nausea or vomiting
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Chest pain with pounding heart
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As OD progresses, the person may stop sweating and get very hot
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Seizures/fits (unconscious with jerky muscle spasms or muscle stiffness)
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Stroke (headache, loss of balance, difficulty speaking, numbness or partial paralysis)
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Unconsciousness

Image: Dialated Pupils