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Re: Psychotropic Meds and #$!@! Vitreous Floaters » Simcha

Posted by Rick on November 1, 2001, at 17:45:04

In reply to Re: Psychotropic Meds and #$!@! Vitreous Floaters, posted by Simcha on November 1, 2001, at 12:40:27

>The floaters did not start until the pdoc started me on Celexa. I have one in my left eye that has been particularly annoying. I'm noticing it less lately. I wonder if it's just that I've gotten used to it?

One thing opthamoligists like to say to calm people who seem distressed by floaters is that they can sometimes be spontaneously reabsorbed into the vitreous, i.e. go away. Fortunately for some, this really can happen sometimes, and you may have been lucky enough to have just such a "remission". OTOH, maybe you DID get used to it if it wasn't an extremely intrusive floater.

>Personally I think that the Celexa either caused me to notice the floater. Maybe I was more calm and I slowed down enough to see the floater. -OR- The Celexa really caused the floater.

Hmmm, I was taking Celexa before I switched to Sezone. I even took them together for awhile. But the "main" floater didn't appear until after I had on on Serzone (and Provigil) awhile.

>If this is a side-effect, and there are many others who are complaining about this while taking ADs, why the cover-up? What's the big deal? Are we liable to go blind and they don't want to tell us?

Despite the huge number of people taking certain meds, it's amazing how long some of the drug-induced side-effects can take to be recognized. There ARE some side-effect clearinghouses, but I'm sure they end up with only a fraction of reports on the previously "unknown" side effects.
Then there are more complicating factors:
-- Something reported by 2% of users is going to
get less attention than an effect reported by
15% -- even if it's a serious medical or
quality-of-life issue.
-- The effect may be gradual and insidious,
meaning patients and doctors might not make
the connection to the med; or many of the
drugs users may not take it long enough to
see a given effect. This is all especially
true for effects which can also occur in the
absence of the med. ("It's just a natural
part of aging).
-- Many, if not most, of the time, the suspected
side effect really ISN'T caused by the med.
But when it IS, getting even a strong base
of *anecdotal* evidence can be difficult for
various reasons.
-- Economics and marketing: Look how Smith
Kline allegedly
swept their knowledge of Paxil withdrawal
under the carpet. They said it rarely
happens and even in those cases where they
admit it's occurence it was downplayed and
dubbed with the gentle-sounding
"discontinuation efects" when its really
plain old withdrawal symptoms.

And vision effects, while significant, are
probably a lot less common than Paxil
withdrawal (at least in the short term), and
they don't come at you
like a runaway train.

Finally, say on the subject of floaters,
who is going to fund a study of whether
say, Serzone users are more likely to
develop or perceive them. Surely not the
manufacturer who wants to keep their market
share high. And in the case of floaters
it surely wouldn't be opthamologsts, who
think anyone who could be bothered
by a benign floater -- even if it interferes
with daily activities like driving or computer
work -- is a crybaby. (Although I can assure
you that if someone developed a safe and
effective floater-removal procedure using
easy-to-obtain equipment, opthamologists
would be all over it. I.e., they would
all have dollar-sign shaped floaters filling
their eyes. The new "lasik"? Suddenly they'd
be trying to get their patients to detect the
smallest floater, and telling them how much
their lives would be improved by undergoing
the new "Flosik" procedure.)

Since I've let this devolve into a rant against Opthamologists, I should point out that I thank God for them for doing all they can to prevent blindness. But having worked with GP's and many kinds of specialists, I can say that Eye Doctors tend to have the most smug, parochial mindset of all of them. They have tunnelvision. They need to open their eyes and think a little more holistically. End of Rant.

Oh, one more thing while we're on the subject of side effects? Always remeber that SSRI's -- especially Celexa and Luvox and Prozac and Zoloft -- have a very low incidence of sexual dysfunction. When it does occur, it's usually caused by unresolved depression, not the med. It's amazing how long many or most doctors bought into this, and the drug companies insisted it was true -- even if you DO take into account that some docs or patients might have been reticent to discuss this!







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