Posted by Dispossessed on February 27, 2014, at 15:38:13
Hello,
Its my first time posting here - I have, however, read quite a few posts and it seems that people here really know their stuff.
Anyway, I was wondering what could have caused me to experience a sudden hypersensitivity to SSRIs and their side effects?
Keeping it as short as possible - I was on 20mg of fluoxetine between 2003 and 2011 for 'pure O' OCD and mild depression, which generally worked at minimising anxiety/depression. Even though it wasn't a good idea, I drank alcohol whilst taking it. Anyway, I noticed around mid 2011 that I was starting to feel a bit more restless (now I think it was a glutamate rebound from drinking alcohol the previous evening) and suspected the medication was to blame, given its reputation for being activating. Briefly tried switching to citalopram, 10mg, then 20mg after a week, but experienced a worsening of intrusive thoughts/akathisia and so stopped. I was on citalopram for around 10 days in total.
After a couple of days I felt great no restlessness, no intrusive thoughts. I went for 3 months like this before experiencing worsening depression/anhedonia (I was drinking moderately each day). I tried reinstating 20mg fluoxetine, making a considerable effort to avoid alcohol/caffeine, but experienced horrible akathisia, sexual side effects, restlessness, agitation some of these side effects were new/greatly worsened this time around.
Long story short, since then, I have been unable to tolerate SSRIs at a standard therapeutic dose. I found that fluoxetine was far too activating, sertraline (25mg) caused blurred vision and severe cognitive problems (I took this for 4.5 weeks and none of these side effects went away), fluvoxamine at 50mg gave me akathisia, restless legs and a general sense of dread.
I did however find that just 5mg of citalopram gave me great relief from my anxiety/intrusive thoughts, and had a moderate impact upon depression. At this dose I could tolerate caffeine again and felt nicely calm. However, it caused visual side effects and cognitive dysfunction even though I gave it 5 months, these side effects didnt lessen. I believe that these side effects relate to its antihistamine properties I switched to fluvoxamine afterwards, which, as mentioned above, didnt help me with the physical anxiety I face (though it had minimal impact upon cognition) and when I augmented with quetiapine I experienced the familiar cognitive dysfunction/blurred vision that I did with citalopram, albeit to a greater extent.
What I am therefore asking is why am I so sensitive to the anticholinergic and antihistaminic properties of these drugs, and why does any serotonergic medication at even a low dose cause me akathisia/restlessness? I gave sertraline a month if I was to try it again (or even paroxetine) would the anticholinergic side effects like blurred vision and cognitive dysfunction fade over time, and if so, how long should I wait?
I can tolerate a low dose SSRI (5mg of fluoxetine helped with depression) but need something more to manage the physical anxiety/OCD. Any (non-benzo) suggestions? I have a hypersensitive nervous system, suffer OCD intrusive thoughts, general sense of anhedonia, poor concentration, fear of change/unfamiliar situations, and physical restlessness. I suspect some of these issues may relate to alcohol use (even though it was never heavy) and so have stopped drinking completely. I have also had blood tests to rule out any physical causes.
Many thanks for reading.
poster:Dispossessed
thread:1061454
URL: http://www.dr-bob.org/babble/20140214/msgs/1061454.html