Cyproheptadine For COVID-19

[Tim Lundeen]

COVID-19

Role of Serotonin Toxicity on Neurologic and Cerebral Manifestations

Proposed Role of Cyproheptadine

Farid Jalali MD - Aug 2020


https://t.co/HgjcANDWmD

 

[mrchibbs]

 

[mrchibbs]

Great find!

 

[Soren]

I think I am currently suffering from Covid 19 and the main symptom I have his headaches and some slight body aches. Cyproheptadine has definitely helped relieve the symptoms.

 

[Perry Staltic]

I think a lot of covid is actually serotonin syndrome (SS). The constellation of pharmaceuticals that can cause SS, either by themselves or in combination with other meds, is absolutely mind boggling. SS symptoms are very similar to covid symptoms. I went through a list of SS symptoms, searched for each symptom + covid, and started laughing when I saw how much they match.

The chances of someone showing up at a hospital with SS are great, and few doctors know how to diagnose it (having monitored Farid's conversations on twitter for a while it's easy to see he's an outlier and a bit of a maverick). People were showing up at hospitals with SS before covid, but it was diagnosed as something else. Now covid's the scapegoat.

 

[Perry Staltic]

Since this is my current path of investigation, I think I might post some of my bookmarked articles/papers.

Check out how clueless and resistant doctors are to a serotinin syndrome diagnosis - to the point of letting someone die. I'm beginning to think that many doctors are incompetent monsters.

In the hospital, I tried to tell every doctor what her history was with the SSRI. I am a medically trained professional in neuroscience and though not a medical doctor but a researcher, I can identify a serotonin syndrome when I see one as long as I know the history that led up to it.

For my biggest surprise, and why I am writing this article, is that physicians rarely recognize serotonin syndrome. No one believed me when I told them that I suspected that my mother was suffering from serotonin syndrome. No one listened to me when I asked that they test for serotonin syndrome. I received comments like this from a psychiatrist: “Your mother cannot have serotonin syndrome, it is too rare.” Serotonin syndrome is not rare but the doctors who identify it are, and he was one of the many who did not recognize serotonin syndrome when he saw it. Another doctor told me that “she may have serotonin syndrome but we cannot test for that and cannot treat for it.” In fact, testing and treatment are both available for serotonin syndrome. The problem is with the doctors who do not ask any questions and only make assumptions based on the patient’s age (she was 88 at this time) using profiling assume that anyone over the age of 80 must have dementia. They diagnosed my mother with Alzheimer’s type dementia (something we were able to see via autopsy to have been the wrong diagnosis). She was misdiagnosed and mistreated with the wrong medicines until she died. There was nothing I could do. I suspect that for those of you who are not scientists like I am, the task is even more daunting. So prepare for the fight of a lifetime.

Silent Death – Serotonin Syndrome- Hormones Matter

It started very slowly and was unnoticeable at first, the serotonin syndrome that eventually killed my mother.

www.hormonesmatter.com

 

[Perry Staltic]

I didn't come up with the idea that covid is a serotonin syndrome (SS). Farid did. I think he's wrong, though, that it can't be caused by a drug. Just check out the expansive constellation of meds that can cause SS and you will see how easy it is for someone to mix the wrong drugs/supplements and fall into trouble.

 

[Perry Staltic]

When doctors practice their dark art of ritual intubation patients must be sedated (opioids) so they don't fight having their lungs and health destroyed by unnatural pressure. Opioids can be serotonergic (increase serotonin), either alone or in combination with other serotonergic meds, like SSRIs and antidepressants. Covid patients typically start going downhill 24 hours or so after being intubated. Wonder why...

Serotonin syndrome precipitated by fentanyl during procedural sedation - PubMed

Fentanyl is frequently used for analgesia during emergency procedures. We present the cases of 2 patients who developed agitation and delirium after intravenous fentanyl administration. These patients were chronically taking selective serotonin reuptake inhibitors (SSRIs). Both developed...

pubmed.ncbi.nlm.nih.gov

 

[Perry Staltic]

When doctors practice their dark art of ritual intubation patients must be sedated (opioids) so they don't fight having their lungs and health destroyed by unnatural pressure. Opioids can be serotonergic (increase serotonin), either alone or in combination with other serotonergic meds, like SSRIs and antidepressants. Covid patients typically start going downhill 24 hours or so after being intubated. Wonder why...

Serotonin syndrome precipitated by fentanyl during procedural sedation - PubMed

Fentanyl is frequently used for analgesia during emergency procedures. We present the cases of 2 patients who developed agitation and delirium after intravenous fentanyl administration. These patients were chronically taking selective serotonin reuptake inhibitors (SSRIs). Both developed...

pubmed.ncbi.nlm.nih.gov

Falid gets it. At least he's halfway there. Now connect the dots and consider the possibility it wasn't covid, or only covid, that put the patient in ICU in the first place, but drug-induced serotonin syndrome did.

 

[Perry Staltic]

Imagine how many people take one or more of these things,

Widespread ignorance of the [serotonin] syndrome is another diagnostic impediment. But even when doctors know about it, the strict diagnostic criteria may rule out “what are now recognized as mild, early or subacute stages of the disorder,” Dr. Boyer and Dr. Shannon wrote.

Perhaps adding to the diagnostic challenge is the fact that a huge number of drugs — prescription, over the counter, recreational and herbal — can trigger the syndrome. In addition to selective serotonin reuptake inhibitors like Zoloft, Prozac and Paxil and serotonin/norepinephrine reuptake inhibitors like Effexor, the list includes tricyclic antidepressants and MAOIs (for monoamine oxidase inhibitors); narcotic painkillers like fentanyl and tramadol; over-the-counter cough and cold remedies containing dextromethorphan; the anticonvulsant valproate; triptans like Imitrex used to treat and prevent migraines; the antibiotic Zyvox (linezolide); antinausea drugs; the anti-Parkinson’s drug L-dopa; the weight-loss drug Meridia (sibutramine); lithium; the dietary supplements tryptophan, St. John’s wort and ginseng; and several drugs of abuse, including ecstasy, LSD, amphetamines, the hallucinogens foxy methoxy and Syrian rue.

A Mix of Medicines That Can Be Lethal (Published 2007)

Serotonin syndrome, a form of drug poisoning, is a not-so-rare and potentially life-threatening disorder.

www.nytimes.com

 

[Tim Lundeen]

Falid gets it. At least he's halfway there. Now connect the dots and consider the possibility it wasn't covid, or only covid, that put the patient in ICU in the first place, but drug-induced serotonin syndrome did.

Thanks for the links, great stuff. Fascinating

 

[Perry Staltic]

Check out the things that can cause serotonin syndrome. All it takes is ODing on one or mixing two or more. Methylene blue is on the list, so if you take it be aware of other serotonergic things that could get you into trouble.

Causative Agents[3]​

Antidepressants​

• SSRIs
• SNRIs
• Buspirone
• TCAs
• Lithium
• Mirtazapine
• Trazodone
• Valproic acid
• MAOIs (should have washout period of 2+ weeks prior to starting a SSRI)
  • Phenelzine
  • Selegiline
  • Tranylcypromine

Drugs of Abuse​

• Cocaine
• Ecstasy (MDMA)
• Methamphetamine
• LSD

Analgesics​

• Fentanyl
• Meperidine (Demerol)
• Methadone
• Tramadol

Antiemetics​

• Metoclopramide
• Ondansetron

Over the counter Medications​

• Dextromethorphan
• Oral decongestants (Pseudoephedrine)

Herbal products​

• St John’s Wort, Ginseng, Nutmeg, Yohimbe

Other Medications​

• Triptans
• Ergot alkaloids
• Bromocriptine
• Linezolid
• Carbamazepine
• Cyclobenzaprine
• L-tryptophan, 5-hydroxytryptophan
• Methylene blue

Serotonin syndrome - WikEM

www.wikem.org

 

[Soren]

In further confirmation of Serotonin being a significant cause of the complications due to covid an update to my own personal experience. I was feeling quite slow mentally and foggy this afternoon after a while since I'd taken any cyproheptadine. I decided to take some metergoline topically another powerful serotonin antagonist to see what the effect would be. It resulted in a rapid improvement in my mental state equal to Cyproheptadine I would say.

 

[Mito]

 

[ddjd]

more success using cyproheptadine

 

[Perry Staltic]

more success using cyproheptadine

A significant factor causing this serotonin toxicity that cyproheptadine is helping is putting patients on fentanyl, which is a 5HT receptor agonist (not sure which receptor). Some hospital Farid knows about stopped using it and saw significant improvement. For full conversation click on tweet, then scroll/read and click "View more replies" and then "Show replies" after Farid's 2nd comment.

Yup while in the first wave we struggled with high doses of fentanyl and high resp drive, no longer an issue on dilaudid, ketamine, propofol and some dexmedo. No fentanyl for me.

 

[Perry Staltic]

A significant factor causing this serotonin toxicity that cyproheptadine is helping is putting patients on fentanyl, which is a 5HT receptor agonist (not sure which receptor). Some hospital Farid knows about stopped using it and saw significant improvement. For full conversation click on tweet, then scroll/read and click "View more replies" and then "Show replies" after Farid's 2nd comment.

Looks looks like 5HT-1A and opioid receptors are responsible for 5HT efflux.

Effect of fentanyl on 5-HT efflux involves both opioid and 5-HT1A receptors

www.ncbi.nlm.nih.gov

SSRI meds can take weeks to clear from the system. A large percentage of the US population takes SSRIs. Fentanyl was heavily used to sedate intubated covid patients (it still is, but not as much). So if intubated covid patients on SSRIs are sedated with fentanyl, guess what can, and most likely will, happen? Serotonin toxicity, ie. serotonin syndrome, especially considering the fact that they add in other serotonergic drugs as well

Serotonin syndrome: fentanyl and selective serotonin reuptake inhibitor interactions - PubMed

Serotonin syndrome is a rare but potentially fatal adverse drug reaction associated with increased serotonergic activity in the central nervous system. It is characterized by a triad of symptoms, which include altered mental status, neuromuscular hyperactivity, and autonomic instability or...

pubmed.ncbi.nlm.nih.gov

 

[Peater Griffin]

This is very interesting, but the latest posts make me question if cypro even helps with covid infection itself or just with the horrible side effects of mainstream treatment of it (fentanyl, intubation, etc). If I catched covid but avoided the standard medical treatment, would I even benefit from taking cypro?

 

[Perry Staltic]

This is very interesting, but the latest posts make me question if cypro even helps with covid infection itself or just with the horrible side effects of mainstream treatment of it (fentanyl, intubation, etc). If I catched covid but avoided the standard medical treatment, would I even benefit from taking cypro?

That's a really good question and lies at the heart of this dilemma. How much morbidity is being caused by the virus itself and how much is being caused by medical treatments, some part of which causes or triggers serotonin toxicity/poisoning? I suspect covid is by itself comparable to the common cold and medical treatments coupled with compromised patient health due to prior chronic pharmaceutical use are responsible for the vast majority of mayhem and death. Cyproheptadine might or probably would be helpful if serotonin is elevated in mild cases, but certainly not as much as in severe cases where patients are dying of serotonin poisoning (and other things) due to medical treatments.

 

[Perry Staltic]

Just parking this here as a reminder how covid treatments can trigger serotonin poisoning (scroll down page for full text). Lopinavir/ritonavir was, and maybe still is, used as an antiviral treatment for covid. Ritonavir inhibits liver enzymes responsible for metabolizing drugs, so it can cause serotonergic drugs to be more potent, which is apparently what happened in these two cases.
.

Serotonin syndrome in two COVID-19 patients treated with lopinavir/ritonavir | Request PDF

Request PDF | On May 1, 2020, Miguel Mas Serrano and others published Serotonin syndrome in two COVID-19 patients treated with lopinavir/ritonavir | Find, read and cite all the research you need on ResearchGate

www.researchgate.net