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Dizziness, vertigo, light-headedness, rocking or swaying sensations

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apace41
2 hours ago, Altostrata said:

While vertigo can be a withdrawal symptom, I recently had a bout of vertigo that seems to be due to a common inner ear problem that can come and go, especially in older people.

 

In that particular case, Alto, where the cause of the vertigo is BPPV (benign paroxysmal positional vertigo), the so-called Epley Maneuver (which is what the video demonstrates) can provide instantaneous relief.  If only all vertigo were so simple.  There are a wide variety of dizziness maladies some of which create spinning sensations and others of which create "floating" or "walking on a trampoline" sensations.  Still other dizziness is a migraine variant which makes it very difficult to treat.  Of course, dizziness is a subjective symptom so how the sufferer describes it can be critical to the treatment that is given.  The most recent entry into the world of dizziness is PPPD (persistent postural perceptual dizziness) which seems to be a mismatch between inputs and outputs from the brain and is a purely subjective issue (one that is closely tied to anxiety).  

 

Some of these symptoms can well be triggered by withdrawal, others can be independent of it.  I would say, from years of personal challenge with this, that figuring out what is what is not an easy feat.  People who are NOT in withdrawal can take years to get a diagnosis in the dizziness arena.  Withdrawal only makes it that much more confusing.

 

Ironically, or not so much, the first line of treatment for many of these balance disorders is... antidepressants (usually in low dose) with SSRIs being a frequent "go to" drug and one of the top doctors in this space a strong proponent of Effexor as the first line treatment.  Can't make this stuff up.

 

Best,

 

Andy


Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Altostrata

That is true, @apace41. I mention my experience only for those who might want to try a relatively easy and harmless maneuver that can help. It's not going to work for everyone and probably won't work for withdrawal-related vertigo. (The Epley maneuver is different; there are a half-dozen of these positional treatments. In the video, the doctor says if her "half-somersault" doesn't work, go to your doctor to have Epley, etc. applied.)

 

But it is possible that some of our members who experience dizziness coincidentally have benign paroxysmal positional vertigo, a common age-related condition.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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apace41
2 hours ago, Altostrata said:

But it is possible that some of our members who experience dizziness coincidentally have benign paroxysmal positional vertigo, a common age-related condition.

 

Agreed, Alto.  Wasn't intending to be confrontational.  I'm very hypersensitive to the dizziness issue because of years of struggle.

 

It's a difficult symptom and is very hard to understand.

 

Best,

 

Andy


Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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bunchesofoats
Posted (edited)

What causes dizziness/vertigo?

 

I've been trying to understand exactly what is the mechanism behind this side effect/withdrawal symptom. I'm curious if anyone has found any good information, research papers, etc.

 

I'm also wondering what others have found (if anything) helps alleviate this particular symptom. Before I had any idea it was related to my taking of SSRI's I thought it might be labyrinthitis and took NSAIDs. It did seem like maybe that helped. Could've been placebo, or could've worked because perhaps inflammation plays a role in the vertigo caused by SSRIs.

 

Edited by ChessieCat
added topic title

2005-2009 18mg concerta on and off

2009-2013 ritalin and wellbutrin on and off; 2010 nortryptyline & amitriptyline for back pain following car accident

2014 April - lamictal for 2 weeks until breaking out in hives and going to ER, dr bullied me into taking it

~ st. john's wort, rhodiola, lots of other supplements tried

2016 Nov - began citalopram (4 months)

2017 March  - reached dose of 30mg citalopram (11 months)

2018 Feb - began taper, ~2.5mg/month, cutting tablets (3 months)

2018 May - 20mg, tried ~17.5mg but symptoms too strong (11 months)

2018 Nov - brief stint trying wellbutrin again, stopped within a couple months

2019 April - began ~5%/month taper from 20mg using dissolve in water and measure with syringe method

2020 January - stopped lorazepam; 0.5mg lorazepam average 3x/month since began citalopram; at most 3x/week

2020 August - 10.45mg, 4%/month taper with .45% reductions every 5 days (approx)

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AlanC

"A possible explanation for dizziness following SSRI discontinuation" by Paul F Smith & Cynthia L Darlington, University of Otago

 

Abstract:

 

Dizziness is the most commonly reported symptom of abrupt discontinuation from the selective serotonin reuptake inhibitor (SSRI) category of antidepressants. The reported dizziness is exacerbated by even slight head movement, and therefore is likely to be vestibular in origin. The SSRIs most implicated are those with short half-lives and which are most selective for serotonin (as opposed to noradrenaline), e.g. paroxetine and sertraline. Since the vestibular nucleus complex (VNC) has an abundance of serotonin receptors, the abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it. Here we suggest that the abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo.

 

https://www.researchgate.net/publication/41418537_A_possible_explanation_for_dizziness_following_SSRI_discontinuation

 

...

 

I've suffered from this for around two years. It's extremely variable: there have been periods where I could walk for miles with no problems, and others where I have to have a stick to keep my balance. I've even had a couple of falls because of it. Unfortunately I haven't found anything that helps: it's always been a question of waiting for it to go away.


1999 - 2001: Paroxetine 20mg

1999 - December 2017: Lansoprazole 15mg

2003: Venlafaxine 75mg

2003 - 2014: Escitalopram 20mg

2014 - December 2017: Citalopram 20mg

December 2017: Mirtazapine 30mg

December 2017: Zopiclone 3.75mg

January 2018 - April 2018: Citalopram liquid, tapering

December 2018 onwards: Vitamin C 1000mg

Long term (for asthma): Salbutamol and Salmeterol inhalers

Occasional use for headaches: Paracetamol 40mg or Ibuprofen 40mg

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ChessieCat

merged similar topics


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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bunchesofoats

Thanks @AlanC for the good info. I was at 30mg citalopram which meant taking 1.5 tablets of 20mg (that's how my doctor prescribed them). I wasn't changing dosages (intentionally) but due to the nature of cutting a tablet in half, the dosages were never really exactly consistent. I had horrible bouts of vertigo during this time. They would last for a week or two, and I would have to grab on to the bed even while I was lying down. I didn't connect it to the citalopram until I tapered down to 20mg and realized I suddenly didn't experience the vertigo at all anymore.

 

I've now been tapering very, very slowly, and haven't felt anything as severe as I did while at 30mg, but I have had my moments. I try to be a lot more consistent with my dosages now by dissolving a tablet in water, mixing well, and measuring to the same part of the line on the syringe, but I know that has its limits as well. I'm now tuned in enough to notice even a slight feeling of dizziness in my head, usually when I wake up in the middle of the night or the morning, but during the day I hardly ever experience it (and this is only when I experience it, which is not every day).

 

To add to previous posts in the thread, I also tried the Epley maneuver countless times thinking it may be BPPV. It never helped, and often sent me into worse spins. I'm on the younger side (early 30s) where it's not so common. Thanks @ChessieCat for merging the threads.


2005-2009 18mg concerta on and off

2009-2013 ritalin and wellbutrin on and off; 2010 nortryptyline & amitriptyline for back pain following car accident

2014 April - lamictal for 2 weeks until breaking out in hives and going to ER, dr bullied me into taking it

~ st. john's wort, rhodiola, lots of other supplements tried

2016 Nov - began citalopram (4 months)

2017 March  - reached dose of 30mg citalopram (11 months)

2018 Feb - began taper, ~2.5mg/month, cutting tablets (3 months)

2018 May - 20mg, tried ~17.5mg but symptoms too strong (11 months)

2018 Nov - brief stint trying wellbutrin again, stopped within a couple months

2019 April - began ~5%/month taper from 20mg using dissolve in water and measure with syringe method

2020 January - stopped lorazepam; 0.5mg lorazepam average 3x/month since began citalopram; at most 3x/week

2020 August - 10.45mg, 4%/month taper with .45% reductions every 5 days (approx)

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Kelmo137
On 7/13/2011 at 1:21 PM, Altostrata said:

Well, at least the physical therapist will be paying attention to you. I've found they are very smart and empathetic.

why would a physical therapist be useful during withdrawl?

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