SoundPeace: Do serotonin receptors regenerate?

[SoundPeace]

 

I found the following information interesting. It was written by an ex physician from ICU called Tony Jay, in response to the question: 'Do serotonin receptors regenerate?'

 

All receptors are produced by the cell that expresses them and all these receptors are continually produced.

I am not exactly certain what you mean by the word “regenerate”, however the binding of nearly all (but not all) drugs, hormones, and neurotransmitters to receptors is temporary and occurs without directly damaging the receptor in any way. Whether a receptor is bound by a ligand really is dependent on the local concentration of the ligand.

If a ligand does bind to a receptor in a permanent fashion then that receptor will not continue to function and the cell will internalize that receptor and destroy it and externalize new receptor proteins.

Over time all receptors degrade and become non-functional. This is not a problem since the cell is continually producing new receptors to replace old ones.

These principles apply to serotonin receptors too….

 

Here's the source: 

https://www.quora.com/Do-serotonin-receptors-regenerate

Edited July 5, 2023 by manymoretodays
name okay

[SoundPeace]

Hello,

 

I've just joined.  I am a 52 old male and I live in London, UK. I am currently suffering from what I believe to be protracted withdrawal symptoms from Escitalopram: paraesthesia (burning skin sensation), brain fog, numbness, insomnia, tinnitus, derealisation/depersonalisation, poor resistance to stress and loud sounds, ‘background’ anxiety with nothing specific to point at, fatigue and muscle aches.

 

SSRI history

 

After a late teenage history throughout my twenties of panic attacks and agoraphobia I finally let myself try an SSRI. I was scared of antidepressants as the three attempt I'd previously had trying different ones over the years (one dose only each time) had resulted in a horrible and frightening reaction, ranging from what I believe was Serotonin Syndrome and panic attacks.

 

But, unexpectedly, in 2003, Citalopram seemed to generate very little side effects on me when I tried it at 10 mg. I never went up form that dose. I took it for 15 years then decided to come off it as I felt it had long stopped doing its job. I had been feeling miserable and demotivated for a number of years. I managed to come off in the space of 2 months, progressively spacing out the doses of 10mg and then stopped. It was easy. I felt great for the next 1.5 months until all hell broke loose and didn't quite understand what had hit me. Symptoms were, constant pain in my legs, paresthesia, insomnia, derealisation/depersonalisation, tearfulness, depression. I became anxious about my symptoms. This went on for about 1.5 years. Meanwhile, not a single medical doctor in my local practice at the time was able to offer any help other than say either:

1) 'We don't know much about the long term effects of using antidepressants and what happens when you come off them, so we tend to assume it's safe'.

2) 'It's your depression and anxiety coming back. You should consider reinstating the treatment.'

3) 'We can't really tell the difference between withdrawal symptoms and those of depression and anxiety'.

 

So basically, no help. I reluctantly I tried reinstating Citalopram 3 times during the 1.5 years, which lifted my mood pretty much instantly each time, but failed to get rid of all the debilitating symptoms I had been experiencing since I had stopped. I felt like I had to take something as I had to find a way to make the Citalopram protracted withdrawal symptoms go in order to be able to keep working or I would lose my mortgage, savings etc.

 

I did this three times and then eventually switched to Escitalopram 5mg on January 2020 for 1.5 years during which time the symptoms never completely disappeared, but with added partial genital anaesthesia from Escitalopram. This time I intuitively worked out that I needed to taper much more slowly for a longer period of time. I asked my Dr to prescribe me a liquid version of Citalopram, which she told me didn't exist. I told her it did and sent her a google link as proof. This was followed by an admission of ignorance on her part and she managed to get hold of some and basically left me to it.

 

Once I'd managed to get down to 1mg (1 drop) I then had to figure out a way to bring the dose down further. As usual not a single Dr or pharmacist made any suggestions. So, after trying various 'home made' techniques that were unreliable (nor precise enough), I finally had a breakthrough when a work colleague of mine suggested using a laboratory micropipette which I had to buy and learn how to use. I worked out that from the prescribed solution one drop was equal to 50 microliters in turn equivalent to 1mg potency. Using the dial on the micropipette I was therefore able to measure precisely and reliably the microdoses I needed in order to taper safely.

 

In February this year I'd managed to obtain an academic consultation with Dr Mark Horrowitz online during which he offered some technical advice on how to taper and at what rate. Unfortunately, and in spite of Dr Horrowitz's advice, I think I went down a little too steep initially (0.70mg) and then carried on more gradually until I stopped at 0.66mg (about 18% SERT occupancy in the brain, which is still considerable).  I didn't want to go up in dose again to try and restabilize perhaps at 1mg. Perhaps I should have but my 'gut feeling' at the time was telling me that this drug is poison and my body is telling me that it doesn't want it. For some time the symptoms had ben getting worse after each time of taking a dose of 0.66 mg. My health started to deteriorate.

 

My blood pressure shot up, I had palpitations at random times, I felt more agitated and anxious. I went to A&E (emergency room) to get checked out several times (ECG & bloods essentially). They all came out ok at that point. In a desperate attempt to put an end to this nightmare I took Citalopram 10mg for 6 days to see if my symptoms would go away, with the hope that after 1.5 years maybe my body would accept it again. Big mistake. I just got worse with agitation, akathesia, and this time I ended up in the psych ward at my local hospital. The consultant said 'I think it's time to review your medication'... I was given some Valium to last me for 7 days and discharged the next morning.

 

I then made the decision to stop taking anymore SSRIs. Valium barely brought me any relief. At this point (Mid April 2023) I called in sick and haven't been back to work since. The first couple of months were a nightmare. I was mostly bed ridden with nausea, dizziness, severe burning skin, severe anxiety and some cardiac arrhythmia. It was scary and very unpleasant. I took propranolol (I had a stash) to help my heart get back into a steady rhythm and to help my body relax a little. I remember putting the central heating radiator on full blast for weeks and hugging it throughout the day and night in order to 'drown out' the debilitating burning skin sensation from severe paresthesia. It felt insane. I thought, ghee, Escitalopram seems more vicious than Citalopram. Eventually, I decided I needed to get a proper health checkout (echocardiogram, 24 hr ECG, blood tests including vitamin deficiencies etc.). All came back ok.  

 

At some stage I thought maybe I could try another SSRI like Sertraline. I tried it for about three days but I felt worse. Last week, I had a bout of Atrial Fibrilation (second time in my life in the space of 20 years) for which I have now been prescribed 2.5 mg of bisoprolol. I take this instead of propranolol as it is more cardioselective than propranolol. As a result I feel less depressed but I also feel more of the protracted withdrawal symptoms (Chronic use of Propranolol can make some people feel a bit depressed).

 

Today

 

As from today (03-07-2023), it has been 11 weeks since I stopped my regular daily intake of Escitalopram, which I stopped at a dose of 0.66mg. I have had a rather chaotic and traumatic three months. I have read, listened to and viewed a vast amount of information online about protracted withdrawal symptoms. I have discovered who the main public figures are in addressing these issues through their work. I have resumed psychotherapy (Psychosynthesis) with a therapist who knows me well. I have been living off a combination of Statutory Sick Pay and some of my savings in order to eat and pay my bills. I have decided to try to return to work for 1/2 day a week initially. I hope to rebuild the resilience I once had before this nightmare. There is a lot of uncertainty there, but it is what it is.

 

I currently suffer from SSRI withdrawal symptoms as described above. I am progressively learning to accept that my body needs time to heal. I am learning to not push myself too hard and be kinder to myself. I get daily physical and psychological set backs whilst slowly and hopefully learning to ground myself. I have a life experience of suffering from various traumas, some of which were physically life threatening as a child (I lost my left foot instantly in a boat accident at the age of 14). I have PTSD which I am hoping to manage through psychotherapy. I've learnt that SSRIs have helped me not worry as much but also gave me a false sense of invulnerability which I feel somewhat stunted my emotional growth. I sometimes wonder if I shouldn't have ever stopped taking Citalopram in the first place. I was depressed at the time leading up to the point I stopped taking it, but still functioning and without debilitating withdrawal symptoms. It feels like I have broken something that I can't glue back together with SSRIs anymore. I am reluctant to try anymore psychotropic drugs. I hope that with time things will get better.

 

SoundPeace

 

 

 

Edited July 5, 2023 by manymoretodays
spacing and font enlargement for ease of readability

[manymoretodays]

Hi there SoundPeace and welcome aboard,

I am unable to view your screenshot, and not sure if that's a reference to the author information you shared in your first post, or a signature.  If a signature, do just type it out and then save, after looking at the topic I'll give you that gives further instructions.  Thanks.

 

You are a detail oriented person and that will be in your favor as your healing continues.

Signatures give us an "at a glance" history of your drugs/medications, and once done will appear below all your posts.  It is different from any of the confidential profile information you gave on registration.  And here is more information on how to do one, and what we like to see there:

How to Summarize your Drug History in your Signature

You've got most of it in your narratives, which I have read, and so now.......just get it into a more concise form, with years, dates, drugs and doses.  This will help us help you tremendously.  Thanks.

 

I did do some spacing and enlarged the font in your second post for greater ease of readability.  No other changes.

It does sound like you are now well read around WD(withdrawal) and also may have also gotten familiar with tapering techniques as well as reinstatements.

 

I'm sorry for how much you have been through to date.  And, with little understanding from your usual providers.......which so many of face when wanting to get off our drugs.

 

Glad to hear you have done an academic update with Mark Horowitz too.  We are very familiar with him here.

 

I wanted to get you approved and started today, and so will just go brief with links to topics that may further help.  And thank you for sharing so much about yourself, as well as what you have learned to date, with references too!

 

 The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

*Why taper by 10% of my dosage?

*Tips for tapering off Lexapro

you'll learn more about this drug ^, and some of it's properties

*About reinstating and stabilizing to reduce withdrawal symptoms

I've got to wonder if your reinstates were too high, you'll see how and why we recommend very small doses for reinstatement's in the above.  Ask right here if you might consider another small reinstatement, since you are only 11 weeks out now from your last dose.  We can confer.

 

It sounds like some of your WD symptoms have been intense.  And then possibly kindling or hypersensitive now.

 

 

Dr.Glenmullen’s withdrawal symptom list.

 

The Windows and Waves Pattern of Stabilization  I'm sure hoping you've had some Windows.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.  

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your WD, any reinstatement questions,  give updates, and just keep a record of your journey.  Best to communicate right here, for now, with staff, including mentors and moderators, as well as other members.  Once you know your way around you can branch out a bit and support others too.

 

Best, Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

Edited July 5, 2023 by manymoretodays

[SoundPeace]

Hi Manymortodays,

 

Thank you for your support and guidance. I have read your profile and it is so clear the amount of experience you have as a survivor of psychotropic drugs. I admire your courage, determination and buoyancy.

I look forward to happy days ahead where I may be able to share some good news about my progress and perhaps be of service to other members.

 

SoundPeace

[SoundPeace]

On 8/6/2020 at 8:52 PM, Altostrata said:

Yes, the autonomic nervous system regulates many things, including blood pressure, heart rate, temperature regulation, muscle tension.

Hello Altostrata, I have just joined. Thanks for all the incredible work you have done and are still doing. It was good to see you on the UK's recent Panorama documentary 'The antidepressant story' along with Mark Horrowitz whom I spoke with back in February this year.

 

I developed high blood pressure whilst on SSRIs for many years and was prescribed Lisinopril 5mg to bring the BP down a bit, which it did. Now that I have quit (in my 12th week since last taper 0.66mg Escitalopram) and going through PAWS, my BP, after going up and down like a yoyo since recently, eventually settled for staying on the lower side (on average 104/69). And then one night it shot up and I also experienced Atrial Fibrilation for which I was given Bisoprolol 2.5 mg. It worked to bring it down in a couple of days but then I was advised to stop Lisinopril as the BP went too low. After 12 days of Bisoprolol I swapped for Nebivolol (another cardio selective beta blocker) with the hope that it wouldn't make me feel anxious or exacerbate my PAWS and PSSD somatic symptoms. I stopped Nebivolol after two days as it affected my PSSD somatic symptoms too severely (including worse insomnia)+ the added physical lethargy from the beta blockers. After doing some research I found out that some beta blockers are lipophilic (fat soluble) and cross the blood brain barrier, whilst others are hydrophilic (water soluble) which either don't cross the blood brain barrier or much less so than lipophilic beta blockers. Due their ability to reach the brain Lipophilic beta blockers therefore affect the Central Nervous System, potential causing a range of adverse effects including:

• Impaired concentration, confusion and abnormal thinking.
• Mood swings including anxiety, agitation, depression, paranoia and euphoria.
• Sleep disturbance including insomnia, drowsiness, vivid dreaming and nightmares.

I have therefore asked my cardiologist, through my GP, to prescribe me Atenolol, a cardioselective hydrophyilic beta blocker, with the hope that I won't experience anxiety or worse insomnia as I had from the previous two beta blockers. I've taken my first dose today, mid afternoon, in case I felt drowsy (I do) with the hope to sleep it off during the night and feel less drowsy in the morning. I was also hoping that it wouldn't make my SSRI PAWS paraesthesia more pronounced, but it has... I hope that I'm not interfering too much with the Peripheral Nervous System PAWS healing process by using Atenolol. It's early stages (first dose today) but my nervous system is so sensitive. The Atenolol side effects are said to often subside after a few days (I hope they do). The drug has already brought my heart rate and BP down to good levels, which is pretty quick acting. If they both go too low after a few days and the PAWS and the Atenolol side effects don't subside then I might be able to suggest to my GP that I could perhaps lower the dose from 25mg to 12.5 mg of Atenolol. I mention all this as I have just seen your Alto Strata Occupy APA 2013 YouTube video in which you give some information on developing Afib and not having the option to use drug therapy due to CNS injury from SSRIs (if I got this right). I hope you are now feeling well and am looking forward to your feedback if applicable. Thank you, SoundPeace. 

[manymoretodays]

Thanks @SoundPeace

Do give a try at creating a signature.  The instructions are linked in my first post here.

 

Any good news on your progress?

 

[SoundPeace]

Hi Manymoretodays,

 

I'm sorry, I thought I had done so. It turns out it looks like I'd done it in the wrong place: in the Profile section...

I think I've done it now, and reduced the content t fit the format. Please see the attached a screenshot of it.

 

Any good news? Hmm, it's difficult to say. In the last 2 to 3 weeks I've been trying to get the right medication for my heart palps so that it doesn't interfere with my CNS recovery. My insomnia sometimes improves for a few days at a time. I'm now experimenting with removing Tyramine from my diet, which is said to raise Blood Pressure, whilst following the Fodmap diet for my IBS. I've bought a health monitoring watch (Fitbit Charge 5) to monitor my heart rate during the day and night, to see if the Atenolol med is working to bring the BP down. So far it is working. Other than that, doing as much resting as I can, combined with walking exercise during the day whenever I can manage. One thing that was noticeable after stopping Escitalopram is that my reading concentration level is better than it was than whilst I was on Escitalopram. This part of my cognitive faculties feels less agitated and stressed under load. I am therefore doing more reading! Hoping to get back to work at least part-time in September. 

I hope you are well.

Best,

SoundPeace

 

[Altostrata]

Thank you. Good to hear your symptoms are diminished. I'm not a cardiologist, so I can't say what's going on.

 

If you have developed serious atrial fibrillation that persists, suggest you see a specialist that treats afib.

[SoundPeace]

Thank you, and yes, I have seen a cardiologist and he has prescribed me 25mg Atenolol which I'm trying out.

It's early days to see how well it works.

 

 

[Altostrata]

Strongly recommend a specialist in atrial fibrillation, not a general cardiologist, if your afib gets worse.

[SoundPeace]

Oh, ok, I will do. So far it seems under control. I hadn't realised that there were Afib specialists as well as general cardiologists.

I'll start looking.

Thank you.

[SoundPeace]

I guess I am going through a new wave since I feel dreadful once again. I have been able to sleep between 4 to 6 hrs a night in the last week though thankfully. It's just the constant pins and needles/burning sensation running through my whole body, scalp and mouth are hard to endure. Activities involving concentration make it worse. I experimented with deep relaxation this afternoon and it did help bring it down quite a bit. But, as soon as I got up and walked about it was back. I'm trying to not let it affect my mood by being philosophical and forgiving but it does feel pretty flat or down. I spend pretty much all my time on my own apart from when I see my therapist and go into work once a week (trying to get back slowly). Taking Atenolol for high BP and arrhythmia doesn't help things at times either. It can make me feel slower and sluggish especially if I have been emotionally upset or stressed. My nervous system isn't what it was when I was taking Lexapro. It feels like it's gone back to its default minus the natural vitality I've always had even before taking the drug. In a way, I feel emotionally more vulnerable as I have lost the 'aggression' Citalopram and Lexapro seemed to boost in me over the years until it turned into depression as the effect wore off. Now I actually do feel more like myself but as a much flatter, injured and weaker version. Pretty much everything in my life is on hold. I have lived a full life and have a wealth of experience but I feel very, very tired of it all. So taking the time to rest and reflect whilst in pain is all I can do right now as well as help to heal my inner child, as encouraged to do so by my therapist. I honestly thought I'd pretty much seen it all, but i was wrong! 

[SoundPeace]

Feeling increasingly tired with paresthesia from the moment I wake up onwards. It's been almost 14 weeks since I stopped Escitalopram at 0.66mg. I tapered over around 2 years and had to stop at 0.66 mg as after every time I ingested the drug I felt ill within 2 to 3 hrs. 

My dep/derealisation symptoms are currently reduced but headaches, muscle aches (thighs especially), paresthesia/burning mouth syndrome, weakness, feeling 'spaced out', restlessness in the evening affect my morale. Tinnitus is always there too. I go for walks which are difficult due to muscle pain and weakness, but do them anyway. I lie down as much as I can to rest the body. It's difficult to know exactly what to put this intensity down to: the use of Atenolol? The use of an antibiotic cream for my eye cyst? It's possible that it is a combination of all the aforementioned + the evolution of the body's recovery process. My prescriber is calling me this morning to discuss how I'm getting on with Atenolol. This drug definitely affects my body with side effects. How much it impacts on my PAWS I don't know. I chose Atenolol as it hardly crosses the blood/brain barrier so that to not interfere with my sleep, which I miraculously seem to get (4-6 hrs a night) according to my Fitbit monitor. Since being in post withdrawal I have not been able to assess or feel the moments I fall asleep or wake up. So I bought a Fitbit to tell me. This device is not 100% accurate but at least it gives me an idea. My sleep curve data seems to match that of my heart rate's so I take this device's reading as fairly accurate.  Anyway, the way I'm feeling now is not what I expected. I guess my situation is not unusual in this community. 

[SoundPeace]

Hi Manymoretodays,

I guess I am going through a new wave since I feel dreadful once again. I have been able to sleep between 4 to 6 hrs a night in the last week though thankfully. It's just the constant pins and needles/burning sensation running through my whole body, scalp and mouth are hard to endure. Activities involving concentration make it worse. I experimented with deep relaxation this afternoon and it did help bring it down quite a bit. But, as soon as I got up and walked about it was back. I'm trying to not let it affect my mood by being philosophical and forgiving but it does feel pretty flat or down. I spend pretty much all my time on my own apart from when I see my therapist and go into work once a week (trying to get back slowly). Taking Atenolol for high BP and arrhythmia doesn't help things at times either. It can make me feel slower and sluggish especially if I have been emotionally upset or stressed. My nervous system isn't what it was when I was taking Lexapro. It feels like it's gone back to its default minus the natural vitality I've always had even before taking the drug. In a way, I feel emotionally more vulnerable as I have lost the 'aggression' Citalopram and Lexapro seemed to boost in me over the years until it turned into depression as the effect wore off. Now I actually do feel more like myself but as a much flatter, injured and weaker version. Pretty much everything in my life is on hold. So I'm taking the time to rest and reflect whilst in pain is all I can do right now as well as help to heal my inner child, as encouraged to do so by my therapist. I honestly thought I'd pretty much seen it all, but i was wrong! I can't work out if the pins and needles/burning I'm feeling around my body and inside my mouth are due to SSRI withdrawal or the Betablocker or both. I've had these symptoms before I took Atenolol and before when I came off Citalopram some years ago, so I guess it's the PAWS more than taking Atenolol. It's strange how even logic doesn't help at times. I feel very, very tired of it all . I hope you're well. 

[Altostrata]

Nobody seems to like withdrawal syndrome. It may take much longer than a few months for your nervous system to settle down.

 

On 7/19/2023 at 1:34 PM, SoundPeace said:

Taking Atenolol for high BP and arrhythmia doesn't help things at times either. It can make me feel slower and sluggish especially if I have been emotionally upset or stressed.

 

You may wish to try lower dosing or split dosing to reduce adverse effects.

[SoundPeace]

Thanks Altostrata,

I experience withdrawal as an evolving thing. It seems to reflect what a lot of people with PAWS describe, with its changes in symptoms (lingering, appearing, disappearing, reappearing). Certain physical improvements also make their way very slowly, and it can feel unexpected. The mind and body feel hypersensitive compared to whilst I was on the drug. The nervous system reacts in a different way. Some internal and external mind and body points of reference sometimes shift or feel alien. It's like being caught up in the Bermuda Triangle when your ship's compass goes wild. 

I'll have a chat with my GP about splitting/changing Atenolol dosage. I'll also ask about the idea of perhaps swapping to a calcium channel blocker at some point if the beta blocker continues to cause side effect problems.

 

[Altostrata]

Withdrawal is an evolving thing. See The Windows and Waves Pattern of Stabilization and other topics here 

 

 

[SoundPeace]

Thanks, yes, it all seems to make sense. Wish I could get rid of pins and needles though. I've had them pretty much every day for the last three months at varying levels of intensity. 

[Altostrata]

How much magnesium and fish oil are you taking?

[Happy2Heal]

On 7/14/2023 at 10:08 AM, SoundPeace said:

 I hadn't realised that there were Afib specialists as well as general cardiologists.

I'll start looking.

cardiac electrophysiologist is what they are called

I have seen two of them, before that I had a regular cardiologist .. they say the main difference is that the EP as they are called for short I believe, works with the electrical system of the heart and the others concentrate on the plumbing, so to speak

 

if it helps any, I had a very high heart rate when I went off of lexapro and while I was on it, I had a half dozen  episodes of afib with rapid ventricular response.

I have not had any episodes since 2020. none! I am now about 5 yrs off of the lexapro

Your results may vary of course but just putting that out there. I might have an episode in the future, I don't know but I don't think so. I think my afib was triggered by the lexapro and by a poor diet and being overweight. I have lost all the weight and changed my diet and have a very healthy heart now. 

 

anyway its worth checking in with an EP as Alto suggested

 

[SoundPeace]

Thanks Happy to Heal,

Sounds like a good idea to do that. I'll need to get this checked out.

 

[SoundPeace]

Hi Altostrata,

 

Magnesium 200 mg/day

 

Omega 3 Fish oil: was taking 500 mg day and in last 3 days upped to 2000mg/day, but then stopped due to something I read yesterday saying that Omega 3 should be avoided with people at risk of developing heart rhythm disorders, quote: '‘Our study suggests that fish oil supplements are associated with a significantly greater risk of atrial fibrillation in patients at elevated cardiovascular risk. Although one clinical trial indicated beneficial cardiovascular effects of supplementation, the risk for atrial fibrillation should be considered when such agents are prescribed or purchased over the counter, especially in individuals susceptible to developing the heart rhythm disorder.' 

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756005/

Other sources say it's ok to get Omega 3 from food. 

 

I swapped Omega 3 for  Folic Acid (400 micrograms) + Vitamin E (400 I.U.) a day from yesterday and give it a go.

 

 

 

 

[SoundPeace]

I forgot t mention I've added Vitamin C too.

[SoundPeace]

I've just updated my signature as some symptoms have improved/changed/newly appeared.

[SoundPeace]

It would seem that as my PSSD numbing effect symptoms reduce the pins and needles, zaps and muscle spasms mainly simultaneously increase in frequency and amplitude. At this stage I imagine my nervous system is slowly 'waking up' and progressively regaining territory in its ability to feel and send me feedback, but perhaps in a less regulated, clunky and oversensitive way. If new nerve cells/neurons are growing or up-regulating I guess they or/and other parts of the body might need to relearn to interpret signals in a more balanced way. In other words, is my body trying to find its way in its post SSRI withdrawal context? I suppose many of us would confirm this. Frustratingly though, one of the most difficult things for me to experience is constant skepticism that can fuel anxiety in the face of intuitive belief in recovery from SSRIs. A certain amount of skepticism is key to logical and constructive thinking. But it seems to me that the debilitating effects of PAWS are anxiogenic enough to shift the skeptical/intuitive belief balance towards skepticism. This in turn can make me feel uncertain about the road I have taken. Thankfully though, I can remember a time when I never had any PAWS symptoms and therefore am able to re-link PAWS to SSRI chronic treatment termination. A naturally inquisitive mind may need reassurance in the face of uncertainty, exacerbated by incapacity to function 'normally'. I understand that in this forum we are dealing with a shared experience that has been either ignored or denied by established medical practice for so long, in spite of documented evidence going back to the 1950s with Tricyclics. Like many other people I do find exploring new territories exciting, for sure, but it's nice to have a safe way out when required. It often feels like SSRI treatment denies that 'certainty' for a lot of us when we come off. Thankfully, an increasing number of medical practitioners (in the UK at least) are becoming more familiar with SSRI PAWS as the number of sufferers grow and come to light through the media and in their surgeries. For instance, I spoke with a psychiatrist in London last month who was aware or even perhaps familiar with SSRI PAWS. I'm trying to get the best out of this horrible SSRI PAWS situation and learn as much as I can. Like many others, I wish to be able to go back to work and build new relationships with a fresh outlook on life.

 

In 2002 I took Citalopram believing it would help me with preventing Afib triggered by anxiety and depression. Indeed I had experienced one episode of Afib 21 years ago. After eliminating any physical causes the cardiologist suggested I took SSRIs for the rest of my life or 'my life would be hell', as he'd identified the Afib causes down to emotional triggers. I was still skeptical. I went to see my GP who had long been trying to push SSRIs onto me, but interestingly he didn't really see the correlation the cardiologist had made, although I have since seen some indications of research in this area supporting this theory. But the GP still thought I should give it a go. So I did, based on what the cardiologist had said. I guess he was right in a way as I never had an Afib episode whilst on them. My second episode indeed happened recently about 2.5 months after stopping Lexapro. Neither Citalopram or Escitalopram prevented me from feeling depressed or anxious at times but gave me a belied that I was now 'safe' from Afib. Was it placebo ( I never went over 10 mg Citalopram or 5 mg Escitalopram), or was it actually doing something physically therapeutic? It's hard to tell. My best guess is that perhaps for the first 2 or 5 years I dwelled less on things and was able to move forward. Perhaps I had more 'confidence' and was more focused. Then, after that, I don't know. I think my body and mind got used to the idea that without it my life would fall apart.

 

Today my life is different since stopping Lexapro. It gradually got worse as I weaned off until I stopped. I experienced the benefits of tapering over a long period of time, but then these benefits stopped towards the end, turning into horrible symptoms every time I took it, as if my body was rejecting it. I lost the ability to work, I saw the end of my loving relationship (we are still friends thankfully), I have an increase in anhedonia, persistent paraesthesia, fatigue, headaches and dizziness. My sleep and PSSD seem to have recovered (for now at least). Whilst on SSRIs for 20 years I gained some life experience and no longer feel so anxious or depressed about things I did in my early 30s. I am in therapy, supposedly healing my inner child from all the trauma (which is genuine and serious) by letting my body feel the pain rather than have it numbed by medication. How long I can keep this up, I don't know. I hope it helps me. Dealing with the Afib effectively without intolerable medication side effects would be nice. I am making appointments with a specialist and will also take the opportunity to discuss the SSRI for Afib prevention theory with them and get their opinion out of interest. In the meantime SSRI PAWS is a real thing and I am recovering from it, slowly and painfully. The body does its thing regardless and I hope to progressively suffer less as a result.  I don't think SSRIs are necessarily the answer for me anymore, and I'm not entirely convinced that they ever were in the first place, although they may have worked for some time. This is a long and sometimes confusing journey and seemingly inevitable for now. Like many on this sight and elsewhere, I don't give up easily. I try to be as thorough and transparent as I can in the hope of finding solutions along the way. As far as sharing solutions, I can confirm that tapering over a long period of time does reduce the intensity of many of the withdrawal symptoms. And, as predicted it got much more difficult towards the end. I chose to end it at 0.66mg, which was too soon in hindsight. I could have perhaps gone back up to 0.80mg but I was so keen to get off I lost patience as the withdrawal effects got worse. I guess this is why I have been experiencing severe PAWS since, with slow and gradual improvements that I have mentioned. 

[Happy2Heal]

wow, first time I've heard of a dr recommending an SSRI for afib, interesting! Dr told me that the lexapro was probably a factor in causing the episodes. 

I was in several info and support groups for afib and if I remember correctly afib is primarily caused by misplaced electrical cells within the heart that are misfiring, and going in and ablating these cells or clusters of them can reduce and in some cases stop afib episodes

 

a second ablation is often but not always needed

it's good you are going to see an EP, they are the only ones who do ablations and will also know all the latest and best treatments

 

43 minutes ago, SoundPeace said:

I don't give up easily.

 

yes we can see that! you were very patient tapering over several years as you did, good for you!

it's discouraging that even after doing so you're still experiencing symptoms but if you take a look at the threads of those who are post Zero you'll see this is fairly common

 

a lot more healing goes on after you take your last dose

you should expect to see things improve over the next few years

 

I am five years off and thought I was nearly fully healed after the first year off, but I am continuing to see small but definite improvements

Little things like being totally comfortable being alone, when before I would get a bit anxious if I didn't go out nearly every day, things like that

 

oh has your cardiologist ever mentioned Magnesium Taurate? It was recommended to me for ectopic beats and I find it works wonders

 

I stopped taking it because my afib had gone away but I was still having annoying runs of PVCs and PACs and since I take magnesium anyway, decided to give it a try again and I've not had an ectopic beat since, 

 

I get this one:https://www.amazon.com/Cardiovascular-Research-EFM-MGT180X2-Capsules-Magnesium/dp/B076PK7FB8/ref=asc_df_B076PK7FB8/?tag=hyprod-20&linkCode=df0&hvadid=312075031577&hvpos=&hvnetw=g&hvrand=14798605274218941486&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9002293&hvtargid=pla-574034778612&psc=1

 

 

 

Edited July 26, 2023 by Happy2Heal

[SoundPeace]

Thanks Happy2Heal,

It's good to hear that your healing has gone well and that you no longer have Afib

I need to see the Cardiologist first regarding a possible alternative for Atenolol, as he has seen me before for some tests relating to PVCs and high BP. I'll ask him about Magnesium Taurate (thanks for the link) and try some in the mean time. I'll also talk to him about Afib and ask him if he can recommend an EP I could see or what he thinks about these guys https://londonafcentre.com/what-is-catheter-ablation-for-atrial-fibrillation/

Thank you for your ongoing support. I'll update as I go along

 

[Altostrata]

I am skeptical that omega-3 fatty acids play a significant role in the development of afib. However, you don't have to take them.

 

Magnesium is best taken in small doses throughout the day.

 

18 hours ago, SoundPeace said:

I've just updated my signature as some symptoms have improved/changed/newly appeared.

 

Keeping in mind that I don't have a lot of time to read long accounts, please summarize which symptoms have improved and which have newly appeared.

 

14 hours ago, SoundPeace said:

In 2002 I took Citalopram believing it would help me with preventing Afib triggered by anxiety and depression.

 

You had pre-existing afib? This is an important fact not previously disclosed. Warnings have been issued about adverse cardiac effects of citalopram and its sibling escitalopram (Lexapro).

 

It is possible that you have withdrawal symptoms (burning skin, etc.) but the afib is a different condition.

 

If I were you, I'd see cardiac electrophysiologist, as @Happy2Heal suggested. The medical centers with specialists trained in radio frequency ablation by Dr. Andrea Natale are the best in the world. In the UK, this doctor might be one of them https://drboonlim.co.uk/about-dr-boon-lim/ (he trained at one of the best centers, Bordeaux University Hospital
Bordeaux, France). I had the rf ablation procedure done at another of the centers, here in San Francisco.

 

 

[SoundPeace]

Yes, there is a dose related QT interval prolongation effect with these drugs. With Citalopram I never went above 10mg and Escitalopram I kept it at 5m until I started tapering. Thanks for the EP links. I will get an appointment sorted out.

There was only one instance of Afib prior to taking Citalopram in 2001. It never returned until a few weeks ago after stopping Escitalopram since mid April this year. I had forgotten about the earlier incident until recently. 

 

PAWS that persist :

- pins and needles/burning around body, arms, legs, face, mouth and scalp. They vary in intensity throughout the day.

- aching and tired leg muscles.

- feeling 'spaced out' as if a little drunk

- flu like symptoms felt in the evening 

- restlessness from mid to late afternoon

 

PAWS that are significantly improving:

- PSSD

- sleep 

 

PAWS that come and go:

- Depersonalisation/Derealisation

- anxiety 

- nausea

- depression

 

Things I do to help:

- Exercise works for alleviating depression. I walk almost everyday for an hour, but it is often uncomfortable to get going due to persisting PAWS.

- resting as much as possible (lying down) and deep breathing to help with anxiety and restlessness.

- I eat regularly and avoid sugar and refined carbohydrates.

- I don't drink alcohol, don't smoke, don't drink tea or coffee.

- I sometimes have a camomille tea and drink water throughout the day to keep hydrated.

- I read and listen to radio/podcasts.

- speak with friends over the phone.

- do my shopping regularly for basic necessities.

 

Voilà!

 

 

 

 

 

 

[SoundPeace]

Did the ablation work well for you? 

[Happy2Heal]

not Alto but the success of ablation is based on several factors that can relate to things such as how long you've had afib, if you have any underlying heart conditions, if you have a thyroid issue, etc-  in short, it varies a lot based on many factors some of them unique to each individual. 

 

 

 https://www.stopafib.org/procedures-for-afib/catheter-ablation/success-rates/#:~:text=Some centers today cite success,how different centers measure success.

 

this site also has a forum where you can ask questions and get support specific to afib :

https://forum.stopafib.org/

 

 

[SoundPeace]

Thank you Happy2Heal,

I shall look through this information carefully and make notes prior to my meeting with an EP.

Hoping to get one soon.

[Happy2Heal]

you are very welcome

Just a correction, I was going thru my medical records as I prepare to see an endocrinologist  and I was mistaken, 

I have had 2 very short afib episodes since being completely off the lexapro

One was less than 30 mins long and the other only lasted a little over 2 hrs

I don't think lexapro caused the afib in my case, and I *think* I read that you have to have the underlying electric issue with the rogue cells anyway, to have afib, 

but it surely did seem to exacerbate it.

 

Good luck to you!!

I think you'll be pleased to find that there are treatments that can help you a lot. at least that is my hope!

[SoundPeace]

Thank you and yes, your Afib episodes thankfully looked pretty short. 

From what I have read already there seems to be a number of factors to take into account before deciding on a particular treatment option.

One never stops learning about stuff!

I hope your meeting with the endocrinologist goes well.

 

[Happy2Heal]

3 minutes ago, SoundPeace said:

From what I have read already there seems to be a number of factors to take into account before deciding on a particular treatment option.

One never stops learning about stuff!

this is true! I love to learn new things myself, I only wish I could remember what I learned! 

 

4 minutes ago, SoundPeace said:

I hope your meeting with the endocrinologist goes well.

 

thank you

[SoundPeace]

I'll keep you posted 👍