Psycho-Babble Medication Thread 5503

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

SSRI's and permanent side effects

Posted by Mary on May 2, 1999, at 3:26:31

I posted a similar but much longer letter in a neurological forum over 2 yrs ago,and have gotten a number of responses ( even phone calls) to the following reguarding movement disorders and SSRI's, and would like some updated feedback from this forum.
I was given Paxil 40 mg per day INSTEAD of Pepcid in my Pepcid bottle, while I was on 50 mg of Zoloft. I discovered the error after 11-12 days of taking the meds. and only because of the horrible side effects I had. I at first thought the pepcid wasn't working like my previous stomach med prilosec was, and the other was that I thougt that the Zoloft which had been doing fine was causing bad side effects like my previous Prozac was. At first I had the stomach problems and then soaking nightsweats, then headaches, then numbness, confusion,and I was clumsy. On about the 10th day I noticed shaking all the time (*tremors) and jerking at night (*myoclonus). There were many others to numurous to list. After discovery I was advised to stop all but properly dispensed meds. I then had severe anxiety,burning of my head (like a carpet burn to the back of my head inside)electic shock feelings evey time I moved that ran down my head into my arm and out my hands,a break down, as well as other side effects.
I now after 2 yrs am left with the diagnois of Essential tremor, Myoclonus, Bruxisum, eye and face fasculations, my left side is more effected than my right, atleast the tremor is more noticable there upon task.Head,voice and even lip tremor, I can only take one stair at a time due to the amount of shaking of both my legs upon decent. Botox injections have been recommened by my neurologist for the eye tics(i've had a few embarrassing winks to stranges)as well as some to relax the muscles that are locked up in my left neck area. AT first they ( the Doctors) thought these side effects will wear off, some did, what I have decribed has not and I'm told will not and that they will only progress. My age of onset was 38(almost 39) and I have 3 children 2 under 12. This has not been easy and it apparently won't get any easier.I did not ever have a tremor or have myoclonus prior to this I didn't even know what they were. I take neurontin and clonzapam ( unrelated- I was just dignoised with Chrons and take asacol for that). My question is for anyone with any information or direction to information on studies done on SSRi's and movement disorders. Please E-Mail me with such info. Because I do not want my Neurologist ( who I think is great) to confuse my treatment of health with the lawsuit of the Pharmacy, I have not ask him for such info. I want him to treat me as a patient needing help not a litigant in a law suit. Thank you for your time . Mary

 

Re: SSRI's and permanent side effects

Posted by anne on May 2, 1999, at 16:40:43

In reply to SSRI's and permanent side effects, posted by Mary on May 2, 1999, at 3:26:31

Hi Mary,

Sorry to hear of your problems. There are several people on the dystonia BB who feel their symptoms were caused by medications, neuroleptics (anti-psychotic and anti-emetic) being the most common, but one person attributes her symptoms to less than a week of Prozac. See my posts under "chronic pain, insomnia" for more info. I have multifocal dystonia (a movement disorder) and have seen several neurologists. As depression is common with dystonia, antidepressants are frequently prescribed, including SSRI's. The first one given to me was Zoloft and it unquestionably increased movements but I went back to baseline upon quitting the drug. I even tried it again to be sure and the same thing happened. I had less trouble with Paxil, movement-wise but didn't like the way it made me feel. I'm on Effexor now and had problems with lots of neck spasms but after a about a month I have less neck pain than ever. Possibly, the receptors for the drug down regulate over time and the effects of the drug change. The pathways of most movement disorders are poorly understood and there are different types and causes. One neuologist felt the best antidepressants for people with idiopathic dystonia affect the nor-epi system like Effexor or Pamelor. They also use anticholinergic antidepressants such as Elavil or Doxepin to decrease movements as possibly too much acetylcholine is problematic. If you have permanent effects due to an adverse reaction to drugs, other approaches to treating the movement disorder are used. I hope you are seeing a neurologist who specializes in movement disorders, they are much more knowledgable about appropriate treatment. The dystonia foundation will mail you a list of qualified specialists in your area if you can't find one. BTW most with drug induced movement disorders are not treated with botox, what symptoms is he trying to treat and where is he going to put it?

 

Re: SSRI's and permanent side effects

Posted by Mary on May 3, 1999, at 23:30:13

In reply to Re: SSRI's and permanent side effects, posted by anne on May 2, 1999, at 16:40:43

Dear Anne:
Thank you for your letter and information. The botox injections are to be used to control my eye lid spasms-- top and bottom lids close up, as it to wink it's more bothersome and sometimes embarrassing than anything but when both eyes are soing it at the same time, then it can be dangerous while driving. As far as the neck goes it should help with the locked up muscles, but thats not really a hazard, just uncomfortable. The prednisone I started a couple of weeks ago for Chrones has had some benifit as it has easied some inflamation, I had FUO and a very enlarged Lymp node (removed and benign) and finally after many test found illietis (Chrones) Hopefully a month of prednisone (tapering down each week) will help. I have had more energy and my temp hasn't been over 97.4 since a few days after starting it. Small bowel still gives me paon form time to time though. Again, Thank you for your response and I'll check with the dystonia areas to get more info.
Mary

 

Re: SSRI's and permanent side effects

Posted by JD on May 4, 1999, at 11:32:18

In reply to SSRI's and permanent side effects, posted by Mary on May 2, 1999, at 3:26:31

Mary,
For what it's worth (and without wanting to be too negative about SSRIs use in general), I remember once seeing an abstract regarding a chronic, movement-related REM-sleep disorder that seemed to have been caused by relatively short-term Prozac (fluoxetine). It should be easy to locate in the PubMed database (on the internet) if you're interested.
My best to you,
JD

 

Re: SSRI's and permanent side effects

Posted by saintjames on May 4, 1999, at 15:38:22

In reply to Re: SSRI's and permanent side effects, posted by JD on May 4, 1999, at 11:32:18

Take a look at Dr. Bob tips and tricks site at

http://www.dr-bob.org/tips/tips.html

about Serotonin syndrome and neuroleptic malignant syndrome.

james

 

Re: SSRI's and permanent side effects

Posted by LJA on May 4, 1999, at 20:38:06

In reply to Re: SSRI's and permanent side effects, posted by saintjames on May 4, 1999, at 15:38:22

Mary,

I first took Prozac 20mg in last December for PMS. One morning I woke up with a burning sensation on my head. It hasn't gone away since. One neuro told me I had a headache and put me back on Prozac -- within 5 days I was "burning" from head to toe and could not function. Another tried Pamelor 10mg for pain, and within three days my pain was intolerable. I'm now stuck with a burning scalp, almost five months later. I take Neurontin, which decreases the pain somewhat. No neurologist believes the connection (they all say it's a coincidence) so I've given up on them. I don't know how long this might last. I'm a 35yo mother of 3 small children and this pain is very fatiguing. I wish you well.

 

Re: SSRI's and permanent side effects

Posted by anne on May 4, 1999, at 21:06:26

In reply to Re: SSRI's and permanent side effects, posted by LJA on May 4, 1999, at 20:38:06

Mary,

Didn't mean to sound so negative about the botox - I've been that route and I have mixed feelings about it. If blepharospasm is impacting your life to the point you are not reliable to drive then it sounds like it's time to give it a try. Understand it often takes several attempts to get the dose right, and a competent doc will not give the doses less than a few weeks apart to decrease the risk of building antibodies to the botox. If that happens it will cease to be effective for you and you will lose this option. Many with cervical dystonia use botox but very high doses are used in the large neck and back muscles and these people are most likely to develop antibodies over time. Consider saving the botox for your eyes only and trying other drugs for the cervical dystonia. Ask your doc how many times he has given botox and how many he currently treats. Especially with eyes, placement is crucial for a good result.

I would highly reccomend this website,

http://www.blepharospasm.org/wwwboard/blefro1.html

Best Wishes,
Anne

 

Re: SSRI's and permanent side effects

Posted by Elizabeth on May 6, 1999, at 1:00:50

In reply to SSRI's and permanent side effects, posted by Mary on May 2, 1999, at 3:26:31

Mary, the combination of Paxil and Zoloft could cause something called central serotonin syndrome, which is what you're describing. Some of the symptoms are nausea, diarrhea, sweating (like, your clothes are soaked through), tremor, chattering teeth, muscle rigidity, myoclonus, ataxia (unsteady gait), and confusion or delirium.

It's rare, but not unheard of, to hear of such a bad case of CSS that doesn't involve a monoamine oxidase inhibitor. It may have been more serious because the error was not discovered sooner (so that you kept taking the medications); also, 40mg of Paxil is rather high (10mg is a common starting dose). The mechanism(s) of this syndrome are not well understood.

Though CSS usually resolves within a few days of discontinuing the offending drugs, I *have* heard of one case of long-term sequelae - specifically, extreme rigidity.

I think that your chronic symptoms may conceivably have been induced by the combination of the two SSRIs, but probably not by the abrupt discontinuation (although you do describe common SSRI discontinuation symptoms, in particular the "electric shock" sensations).

Here are a couple of references to articles that mention SSRI-related or -exacerbated movement disorders:

Stolp-Smith KA, Wainberg MC. Antidepressant exacerbation of spacticity. Arch Phys Med Rehabil 1999 Mar; 80(3) 339-42.

Bharucha KJ, Sethi KD. Complex movement disorders induced by fluoxetine. Mov Disord 1996 May; 11(3) 324-6.

Lane RM. SSRI-induced extrapyramidal side effects and akathisia: implications for treatment. J Psychopharmacol 1998; 12(2): 192-214.

Gill HS, DeVane CL, Risch SC. Extrapyramidal symptoms associated with cyclic antidepressant treatment: a review of the literature and consolidating hypotheses. J Clin Psychopharmacol 1997 Oct; 17(5): 377-89.

Leo RJ. Movement disorders associated with the selective serotonin reuptake inhibitors. J Clin Psychiatry 1996 Oct; 57(10): 449-54.

Lane RM, Baldwin D. Selective serotonin reuptake inhibitor-induced serotonin syndrome: a review. J Clin Psychopharmacol 1997 Jun; 17(3): 208-21.

Gerber PE, Lynd LD. Selective serotonin reuptake inhibitor-induced movement disorders. Ann Pharmacother 1998 Jun; 32(6): 692-8.

I'm sorry I can't offer more constructive help. Good luck with things.

 

Re: SSRI's and permanent side effects - JD

Posted by Elizabeth on May 6, 1999, at 1:30:44

In reply to Re: SSRI's and permanent side effects, posted by JD on May 4, 1999, at 11:32:18

> For what it's worth (and without wanting to be too negative about SSRIs use in general), I remember once seeing an abstract regarding a chronic, movement-related REM-sleep disorder that seemed to have been caused by relatively short-term Prozac (fluoxetine). It should be easy to locate in the PubMed database (on the internet) if you're interested.

I'm guessing you mean REM sleep behavior disorder. It seems to be caused by suppression of muscle atonia that normally occurs in REM sleep. It happens less with other antidepressants for various reasons (but can be precipitated by abrupt *withdrawal* of tricyclics, monoamine oxidase inhibitors, or amphetamine). It has occasionally continued for some time after discontinuation of the antidepressant.

To Mary: have you had a sleep study and imaging studies (e.g., MRI)?

 

To Elizabeth/ SSRI's and side effects

Posted by Mayr on May 8, 1999, at 10:45:16

In reply to Re: SSRI's and permanent side effects, posted by Elizabeth on May 6, 1999, at 1:00:50

Elizabeth:
Thank you very much for the information, I have a couple of the articles you named but not all. I have had an MRI and it is fine, (2 yrs ago) No sleep study has been done but was mentioned once by my neurolist, however since I'm on meds (clonipin and Neurotin) to help with the problem, I would have to go off for awhile to get an accurate testing,and I really don't want the frustration of the full effects of the tremors or myocolus to come back. We'll see if it's really needed later. Also, have you heard that the FDA is re-investigating the approval of Prozac and hopfully the other SSRi's. Not sure whatr they are looking for ( possible violient reactions) but I feel that it maybe also due to the may other side effects not strongly listed in the pre-marketing test. If not mistaken Dr. Peter Breggin stated most of the test were only 6 wk trials , not very long huh. Thank you again for your information and best to you.

 

Re: SSRI's and permanent side effects

Posted by RobinR on March 21, 2007, at 22:51:22

In reply to SSRI's and permanent side effects, posted by Mary on May 2, 1999, at 3:26:31

Hello all,
I am hoping people are still reading this thread! Just over 3 months ago I took only 3 doses of Prozac 20mg and experienced at first just an odd early AM awakening, progressing to horrendous insomnia and extreme unrelenting muscle rigidity of neck and trunk muscles that has caused arm and leg weakness, difficulty breathing, and a "fogging" of the mind. I am a single mother and am now losing my job, my income, have no disability because no one will diagnose me with anything ("it's all in my head"), and everything I've worked for over 43 years for. I have been hospitalized at a prominent neurologic hospital, had thousands of dollars worth of testing, and no one can help. Worse, it seems to be progressing. I currently hardly have the strength or cognitive capacity to help advocate for myself. Does anyone have any leads to any help in the phoenix AZ area or even any similar experiences?

 

Re: SSRI's and permanent side effects » RobinR

Posted by FredPotter on March 21, 2007, at 23:20:50

In reply to Re: SSRI's and permanent side effects, posted by RobinR on March 21, 2007, at 22:51:22

Here in New Zealand I can get insurance to pay for an intermittant, mild gastroenterological problem, but for something that threatens to destroy my life or end my career I have to pay for myself and all advice from the psychiatrist I've seen has been nonsense. He charges $315 an hour (about US$160). I will NOT consult him again. I have a feeling that something has permanently screwed me up, Serzone or Zyprexa or Effexor

So the advice "shop around until you can find a good one" isn't practicable. Have you got a friendly GP who'll do what s/he's told? S/he might be able to help you even if s/he doesn't really understand the medical mechanisms Fred

 

Re: SSRI's and permanent side effects

Posted by RobinR on March 21, 2007, at 23:23:46

In reply to Re: SSRI's and permanent side effects » RobinR, posted by FredPotter on March 21, 2007, at 23:20:50

Fred,
Thank you for the reply. No, I cannot even find a GP who will take me seriously. I do not think there is any hope...

 

Re: SSRI's and permanent side effects » RobinR

Posted by FredPotter on March 22, 2007, at 5:57:35

In reply to Re: SSRI's and permanent side effects, posted by RobinR on March 21, 2007, at 23:23:46

Please help Robin with some advice you knowledgeable ones


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