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    Serotonin syndrome occurs when you take medications that cause high levels of the chemical serotonin to accumulate in your body. Serotonin syndrome can occur when you increase the dose of such a drug or add a new drug to your regimen. Certain illegal drugs and dietary supplements also are associated with serotonin syndrome. Serotonin is a chemical your body produces that's needed for your nerve cells and brain to function. But too much serotonin causes symptoms that can range from mild (shivering and diarrhea) to severe (muscle rigidity, fever and seizures). Severe serotonin syndrome can be fatal if not treated. Milder forms of serotonin syndrome may go away within a day of stopping the medications that cause symptoms and, sometimes, taking drugs that block serotonin. is it illegal to order accutane online So-called natural remedies for depression aren't a replacement for medical diagnosis and treatment. However, for some people certain herbal and dietary supplements do seem to work well, but more studies are needed to determine which are most likely to help and what side effects they might cause. Nutritional and dietary supplements are not monitored by the FDA the same way that medications are. You can't always be certain of what you're getting and whether it's safe. It's best to do some research before starting any dietary supplement. Make sure you're buying your supplements from a reputable company, and find out exactly what they contain. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your health care provider before taking any supplements.

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    Do not take sertraline with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking sertraline during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions. Do not use pimozide (Orap®) while you are taking this medicine. Do not use the oral liquid form of sertraline if you are also using disulfiram (Antabuse®). Using these medicines together can cause serious problems. Sertraline may cause a serious condition called serotonin syndrome if taken together with some medicines. Symptoms such as nausea, weight gain or sleep problems can be common initially. For many people, these improve within weeks of starting an antidepressant. In some cases, however, antidepressants cause side effects that don't go away. Talk to your doctor or mental health provider about any side effects you're having. For some antidepressants, monitoring blood levels may help determine the range of effectiveness and to what extent dosage can be adjusted to help reduce side effects. Rarely, antidepressants can cause serious side effects that need to be treated right away. Depending on your heart health and the type of antidepressant you take, periodically you may need an electrocardiogram (ECG) to monitor what's called the QT interval to be sure there is no prolonged interval before or during treatment that could increase your risk of serious irregular heart rhythms (arrhythmia).

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