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Paresthesia: Pins & Needles, Numbness, Tingling, Burning Sensations aka Neuropathy

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Kittygiggles
18 hours ago, Overwatch said:

I'm curious to know anyone here developed the fingertip and toe tingling / buzzing while actually on your normal dose of a SSRI, not tapering / withdrawing, in my case Lexapro?
...My Neurologist didn't even care about my medication history and ordered several MRI's, ultrasounds, nerve conduction testing and 15+ blood tests. I'm now trying to possibly isolate it to the Lexapro and save myself thousands of dollars for potentially unnecessary tests.

Hi,

 

While taking my normal dose of fluoxetine, I was bothered by symptoms like peripheral neuropathy (PN), such as mild to severe tingling in my fingers and toes, often spreading to the entire hands and feet, with impaired sense of touch. Sleeping on my side often resulted in complete loss of sensation in the underlying arm upon waking. Mine is pretty much completely resolved as I reduced fluoxetine. I can't conclude with certainty that fluoxetine was to blame but my health journal has a lot of evidence suggesting this. The other possibilities were low B12 and high B6. PN-like symptoms can be indicative of so many things so there are a lot of benign options one could try before doing anything drastic, such as stopping certain supplements (some can cause PN-like symptoms, such as B6). I would recommend getting the blood tests if they are not too expensive and ask if they can also test your B12 and B6 levels. 

 

I can review my notes but it would take so long as I've been filling my health journal for years now! I can't say for sure that my PN started in the early years of taking fluoxetine but it did disappear the first time I stopped fluoxetine completely, and was most noticeable during reinstatement and stabilization, with it now being a mild, predominantly non-existent problem at my lower (~7mg) dose of fluoxetine. 

 

As you have been to a few doctors, I am sure they have checked your vitals (blood pressure, breathing, heart rate) so it is unlikely to be anything to worry about. I just recommend the blood tests first as they are potentially the quickest and least expensive option and have a good chance of revealing the problem if it isn't just SSRI-related. It could well be the result of Lexapro though but I would always defer to your neurologist as I only have my experience to draw from. 

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Overwatch
3 hours ago, Kittygiggles said:

As you have been to a few doctors, I am sure they have checked your vitals (blood pressure, breathing, heart rate) so it is unlikely to be anything to worry about. I just recommend the blood tests first as they are potentially the quickest and least expensive option and have a good chance of revealing the problem if it isn't just SSRI-related. It could well be the result of Lexapro though but I would always defer to your neurologist as I only have my experience to draw from. 

 

Kitty...thank you for the reply and the information. The only testing I've had so far to address this concern is a blood test checking my vitamin levels (D, B-12, folate) and one that checked for inflammation. They all returned normal values expect the vitamin D which was just one point below the normal range. The extensive testing, including the MRI, 2D Cardiac Doppler, carotid ultrasound and extensive blood work is scheduled for next week. Not enough time to safely taper off Lexapro, and I'm told the blood testing has to be done within hours of the MRI for some reason related to the dye.

 

Regardless, I'm reassured that someone else has indeed had similiar symptoms while on a SSRI and that they do seem to resolve through dose adjustment. I'll keep this thread updated as this situation progresses. Thanks again for your time.

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alyheartsux3

I'm wondering how you can distinguish whether tingling/paresthesia is due to withdrawal from medications, or current medications that you are on.

 

I get pins/needles all over my body intermittently, but if I wear leggings I notice it on my thighs pretty much 24/7. So I'm avoiding pants year round instead of taking another big pharma pill in the next few years. I don't know if latuda or supplements like GABA can cause it, but I've also come off a lot of medications including Lexapro (which I was on for over 2 years and came off quickly working with my doctor last May). 

 

I'm too destabilized to make any more medication changes or go down on Latuda right now, so I am just wearing shorts year round. Just wish I knew how to tell whether it is withdrawal because I've already been in severe withdrawal for about a year. But it sounds like it could last several years so I'm at a loss. 

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littleball
1 hour ago, alyheartsux3 said:

 

I get pins/needles all over my body intermittently, but if I wear leggings I notice it on my thighs pretty much 24/7. 

 

 

Same here, 24/7 since September 2017. It is more likely withdrawal in my personal opinion. 

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Kittygiggles
On 6/30/2018 at 5:32 PM, Overwatch said:

 

Kitty...thank you for the reply and the information. The only testing I've had so far to address this concern is a blood test checking my vitamin levels (D, B-12, folate) and one that checked for inflammation. They all returned normal values expect the vitamin D which was just one point below the normal range. The extensive testing, including the MRI, 2D Cardiac Doppler, carotid ultrasound and extensive blood work is scheduled for next week. Not enough time to safely taper off Lexapro, and I'm told the blood testing has to be done within hours of the MRI for some reason related to the dye.

 

Regardless, I'm reassured that someone else has indeed had similiar symptoms while on a SSRI and that they do seem to resolve through dose adjustment. I'll keep this thread updated as this situation progresses. Thanks again for your time.

 

I hope the blood tests all came back normal for you and you can attribute it safely to your SSRI. Other supplements that can exacerbate or cause tingling or PN-like symptoms are too much zinc and vitamin D (not via sunlight rather by ingestion). I would keep taking normal amounts of vitamin D and zinc though if your blood tests reveal that you need them. Taking magnesium may also relieve tingling and PN-like symptoms. 

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Altostrata
On 7/9/2018 at 10:34 AM, alyheartsux3 said:

I'm wondering how you can distinguish whether tingling/paresthesia is due to withdrawal from medications, or current medications that you are on.

 

You can tell if a drug is causing a reaction by keeping notes of your daily symptom pattern. If you take the drug regularly, the reaction will appear regularly, though sometimes hours later.

 

We often request that members keep daily notes for this very reason. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

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Overwatch
On 7/17/2018 at 11:02 AM, Kittygiggles said:

 

I hope the blood tests all came back normal for you and you can attribute it safely to your SSRI. Other supplements that can exacerbate or cause tingling or PN-like symptoms are too much zinc and vitamin D (not via sunlight rather by ingestion). I would keep taking normal amounts of vitamin D and zinc though if your blood tests reveal that you need them. Taking magnesium may also relieve tingling and PN-like symptoms. 

Yes, the MRI, countless blood tests and several ultrasound style of tests came back normal and clear of any indication as to why this symptom is occurring. I tapered off of the 5mg Lexapro in a matter of a week prior to the medical tests and doing so and zero effect on the symptoms -- both in frequency and intensity. As a shot in the dark, my Neurologist placed me on Gabapentin to see if it has any effect on it. After reading the issues people have had getting off of that medication, I'm less than excited about taking it.

 

Overall, it's very disappointing and still troubling. I was very confident that the tingling would be related to the SSRI, but unless that stuff is still in my system three weeks after my last dose, it isn't the cause. Back in December I finished a fairly quick taper off of Xanax which I had taken at very low dose (less than .5 to .25mg a day) for several years. I am told by benzo withdrawal sufferers that this could be related to that, but it seems odd that these symptoms would appear suddenly months after my last dose.

 

I return to the Neurologist soon and we'll see what direction he wants to take, if any.

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Altostrata

Hundreds of people on this site have had all kinds of tests, neurological and otherwise, to identify the cause of their withdrawal symptoms. They have found nothing. (Very rarely, someone does find a pre-existing condition that might have caused whatever symptoms initially drove them to take psychiatric drugs.)

 

Unless a neurologist has educated himself or herself about withdrawal syndrome, he or she will not be able to help with it, though they may be willing to prescribe various drugs just to see what happens.

 

Overwatch, please put your update and questions in your own Introductions topic. Discussing your drug schedule and symptom pattern here would take this topic off-track.

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lavendertealatte
On 7/9/2018 at 10:34 AM, alyheartsux3 said:

I'm wondering how you can distinguish whether tingling/paresthesia is due to withdrawal from medications, or current medications that you are on.

 

I get pins/needles all over my body intermittently, but if I wear leggings I notice it on my thighs pretty much 24/7. So I'm avoiding pants year round instead of taking another big pharma pill in the next few years. I don't know if latuda or supplements like GABA can cause it, but I've also come off a lot of medications including Lexapro (which I was on for over 2 years and came off quickly working with my doctor last May). 

 

I'm too destabilized to make any more medication changes or go down on Latuda right now, so I am just wearing shorts year round. Just wish I knew how to tell whether it is withdrawal because I've already been in severe withdrawal for about a year. But it sounds like it could last several years so I'm at a loss. 

Aly that's crazy cause I thought I was the only one.. I used to get pins and needles feelings around my wrists, so I avoided long sleeves for the longest time.   

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Gumleaf

 

This thread is fantastic and has just cured me of an anxiety I have suffered for WEEKS.  I thought my body was shutting down!

Reading from top to tail, I can relate to so many people.

 

I started experiencing Parethesia in my hands and feet, not from WD, but after taking a medication (Valdoxan) for about 4 weeks.  

Just as others have stated here, I had problems (and still do) walking, holding things without dropping them and thought I was having a stroke, or that I had MS, Diabetes, or Parkinson’s.  At one point I picked up a pen to write something for the first time In a while and I couldn’t form a single letter properly.  I cried.

 

Having been off the medication for weeks, I’m just waiting for it to all go away! 🙁

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Kittygiggles
On 4/21/2018 at 3:35 AM, Altostrata said:

Dr. David Healy suggests the sensation of burning in withdrawal might be related to sodium channels (one way cells communicate). Potassium counters sodium; for this reason, potassium supplements are used to calm the heart in situations of arrhythmia and sodium should be avoided.

 

If you have symptoms of burning, you might try potassium supplementation (and reduce sodium intake, such as in salt). In the US, potassium supplements are commonly available as 99mg, don't take more than this each day, you can overdose potassium.

 

Please post in this topic to report what effect this has on your symptoms of burning.

 

Well, it is my turn to get back on the paresthesia train. Mine resurfaced in the last few weeks. I have a detailed diary that can link it to three possibilities but I had not considered sodium. I will reduce salt intake and update here, my other options are to reduce vitamin D3, zinc, and have a look at a connection with a levothyroxine increase. I will update again here if I fix this issue again, which I did the first time possibly from reducing vitamin D3 and zinc. 

 

My symptoms are in the hands primarily (the feet too but less noticeable perhaps): tingling, burning, redness, and a sense of pressure, much like an invisible edema that makes closing the hand uncomfortable, as if there's too much fluid in the hands yet with no discernible change in hand volume. It occurs in the evening, before sleeping and persists for almost 16+ hours. Cold air and hand movement may relieve it.

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Kittygiggles

This post is about erythromelalgia (EM). I am a lay person and what follows may be nothing more than ignorant rambling. I apologise for its size.
Symptoms: A cursory search for "erythromelalgia" will yield plenty of photos and details. The symptoms present in the hands and feet commonly, where one will feel burning, generate heat, and develop pressure (perhaps swelling), redness, and tingling. 
Cause: It seems EM is a problem of extreme vasodilation and it isn't a surprise to me that extreme vasoconstriction is also present in many EM sufferers too (such as in the form of Reynaud's phenomenon).   

 

Serotonin, SSRIs, withdrawal, and EM

A simplification of serotonin's vascular effects is that it can cause vasoconstriction and vasodilation. An aspect of this is sodium channels, discussed in this link:-

 

On 4/21/2018 at 3:35 AM, Altostrata said:

Dr. David Healy suggests the sensation of burning in withdrawal might be related to sodium channels (one way cells communicate).


I've found the circumstances below affect my case of EM, which may support the hypothesis that serotonin dysregulation is the root problem (listed in order of certainty and intensity):

1. It strikes when I'm sleepy (lying down doesn't seem to be a factor) - serotonin has a primary role in sleep regulation
2. It is more intense when I increase my levothyroxine dose - fluoxetine and levothyroxine may have a synergistic effect and of course, thyroid hormones regulate serotonin levels (via reuptake inhibition)
3. It is more intense when I eat more frequently than every 48 hours (I usually eat every 22 to 24 hours) - serotonin generation is influenced by food
Therefore serotonin dysregulation (as a result of taking an SSRI or withdrawing from it) may be the original cause of EM in those genetically predisposed to it. 
This means that for many of us, there may not be much more we can do than to wait for our body to recover from SSRI withdrawal and SSRI side effects, by using all the relevant therapeutic tools discussed across SA:-

 

On 7/20/2018 at 1:11 AM, Altostrata said:

Hundreds of people on this site have had all kinds of tests, neurological and otherwise, to identify the cause of their withdrawal symptoms. They have found nothing. (Very rarely, someone does find a pre-existing condition that might have caused whatever symptoms initially drove them to take psychiatric drugs.)


As demonstrated by some in this thread, their EM or neurological symptoms disappeared as they recovered. In my first encounter with this problem about 1.5 years ago, it resolved, possibly spontaneously, during my stabilization period where perhaps serotonin was at a stable level in my body. Here is my best guess about why I am suffering from this again: now that I am withdrawing, my body has more active serotonin transporters so levels are fluctuating. As a lay person, I wonder as well if there is such a thing as iatrogenic serotonin sensitivity, which may present during withdrawal.

 

Despite the possibility that our fate may be sealed for now due to our history with SSRIs, I think that anything that affects vasoactivity is something worth investigating in order to alleviate symptoms. What follows are perhaps the most pertinent facets we may investigate for relief:-
 

- Sodium channels, potassium, and erythromelalgia

On 4/21/2018 at 3:35 AM, Altostrata said:

Potassium counters sodium; for this reason, potassium supplements are used to calm the heart in situations of arrhythmia and sodium should be avoided.

 

If you have symptoms of burning, you might try potassium supplementation (and reduce sodium intake, such as in salt). In the US, potassium supplements are commonly available as 99mg, don't take more than this each day, you can overdose potassium.

 

Please post in this topic to report what effect this has on your symptoms of burning.

 

I am trying to reduce sodium but I am concerned about the adverse cardiovascular effects of ingesting less than 2400mg daily (see the NHANES I, II, and III studies). Are people with EM-like conditions in a special category where reducing sodium is safe and advantageous, at least in the short term? For example, perhaps we utilize sodium in a different way that means we can be healthy with lower levels.

 

I've not had much luck with potassium yet but it is likely too early to tell. Perhaps the 100mg (rounded from 99mg) mentioned above is insufficient, when considering the recommended daily amount is ~3500mg for an average adult. I am taking 400mg. The risk of overdose as far as I know only applies to those with renal insufficiency. Because having healthy kidneys is a prerequisite of taking many supplements, can anyone shed any light on why potassium requires special consideration? I will try to research this more because those of us in withdrawal can have some strange reactions to apparently safe doses of supplements and medication.

 

- Calcium channels, magnesium, and erythromelalgia
Much like the sodium channels hypothesis above, anecdotal evidence (https://www.neurotalk.org/peripheral-neuropathy/179910-erythromelalgia.html) suggests that some people benefit from magnesium supplementation due to its effect on calcium channels. Some people feel worse with magnesium and others feel no difference. I take magnesium but have done throughout withdrawal so it seems a dose change (up or down) would yield more insight, at least in my case. 

 

What now?
I need to undertake more reading about the safety of modifying potassium and sodium levels, I will then alter my levels accordingly. I will try to increase magnesium because I tolerate it well. I will also look at the myriad other things that may affect all this: zinc, selenium, D3, B3, B6, histamines, temperature, etc. I will update this thread when I find the cause of a massive improvement in my case, if that ever happens!

 

I will in the meantime do my best to pretend EM among many other symptoms isn't happening because this iatrogenic mess we all find ourselves in, when contemplated fully, just causes further misery! Acceptance is essential and this quote encapsulates its value using just my kind of humor:-

 

On 9/3/2011 at 9:59 PM, cinephile said:

God, who the hell knows?...You get the idea: on and on and on it goes...I just hate how nebulous all this stuff is: getting to the bottom of any of these symptoms is like pinning jello to a tree. I guess that's why I often don't partake in a lot of "symptoms" discussions because I've been around the SSRI block for so long and know that eventually people realize that there are no answers, just iffy theories at best. There's a strange sense of serene surrender that you get when you fully accept this and don't bash your head against the wall trying to cure whatever weird symptoms you're having. You just go with it, one day at a time, even though it can be awful and you often wonder what the point of carrying on is.

 

What a life...

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Kittygiggles

@Altostrata Thank you. It's a good list of food that I consume and enjoy already but I realize that I've not been meeting my 100% allowance of potassium from diet alone in recent weeks. For example, I used to eat a lot of spinach but for whatever reason, I haven't for a while. I thought about the size of my post and I'd be happy for it to be punted over to my thread, with a link remaining here so as not to clog this thread up. 

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Haleybeans

Hello, everyone! My name is Haley, and I’m new here. But I came to ask, has anyone here taken an SSRI and after quitting had terrible pins and needles/skin crawling/almost zap like sensations in your skin? It’s been the most unsettling symptom I’ve had since I quit, and the most persistent. I get it in my thighs and genital area, but I’m sure others experience it elsewhere. I just want to know if anyone here has recovered from the feeling.

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Asi1309
On 6/25/2019 at 11:54 AM, Haleybeans said:

Hello, everyone! My name is Haley, and I’m new here. But I came to ask, has anyone here taken an SSRI and after quitting had terrible pins and needles/skin crawling/almost zap like sensations in your skin? It’s been the most unsettling symptom I’ve had since I quit, and the most persistent. I get it in my thighs and genital area, but I’m sure others experience it elsewhere. I just want to know if anyone here has recovered from the feeling.

I suffer from exactly that, especially in my legs and when I walk or do any physical activity it'll get worse and keep me up at night...

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jr1985

What’s the difference between this and Akathisia? When the tingling/burning/pins and needles was bad enough I found if I kicked my legs around it kind of disrupted the sensation.  It can also keep me up all night.

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ChessieCat

From https://www.healthline.com/health/akathisia

 

Akasithisia:

 

Quote

 

 
 

People with akathisia feel an uncontrollable urge to move and a sense of restlessness. To relieve the urge, they engage in repetitive movements like these:

  • rocking back and forth while standing or sitting
  • shifting weight from one leg to the other
  • walking in place
  • pacing
  • shuffling while walking
  • lifting the feet as if marching
  • crossing and uncrossing the legs or swinging one leg while sitting

 

 

  •  

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