Kenjamin: Back pain episodes evolved into break through anxiety?

[Kenjamin]

Hey everyone,

 

31yo, Male, Caucasian, 6"4', 260 lbs History of depression and panic disorder. 20mg Celexa, 0.5mg Klonopin

I was in the ER on Monday morning for severe back pain on my middle right side that kept me up all night. It radiated around my right side to above my abdomen a bit, so the ER doc immediately thought it was stomach or gallbladder related. By the time the pain was almost gone, they gave me an IV, and had me swallow Maalox mixed with 2% lidocaine, injected me with 4mg of Zofran, and 20mg of Pepcid. They did an ultrasound and found nothing of significance on my gallbladder except for a small 5mm non-shadowing object. They chalked it up to gastritis and sent me on my way.

 

The next day I woke up with a headache and butterflies in my stomach, I called and asked if it could be a side effect or interaction with my current meds (20mg celexa, 0.5mg Klonopin) and they said no.

 

I had to make an emergency appointment with my psychiatrist because I haven't been eating and my daily symptoms since the ER have been butterflies in the stomach, a weird feeling in my eyes, heart rate near 100 all the time, and no appetite. Occasional minor cramps and pains in my abdomen, but nothing that has worried me. This was 2 days after the ER, and he said it was probably hypoglycemia from not eating anything over 2 days, so on the way home I got some hard candy to suck on and some bland food I could try to force myself to eat. He said there were no interactions with the meds and side effects are unlikely.

 

I had a doc appointment 2 days ago to follow up the ER visit. I've lost 10 lbs, all my blood tests look fine, I don't have diabetes, and I had a urinalysis done which showed high ketones, but that is probably the result of not eating and the rapid weight loss.

 

I still have butterflies in the stomach, don't feel right, and my eyes feel weird with a sort of after image sometimes when looking away from my monitor or looking at something for a while and then looking elsewhere. I'm having to force myself to eat and I finally got up to 800 calories yesterday.

 

I've elevated my klonopin to 1mg daily yesterday and today to see if that will help the symptoms I'm feeling, but my question is:

 

Has anyone had any of these meds on a once-off basis like I had and had breakthrough anxiety for a week or longer? Could this be a coincidence breakthrough anxiety episode that needs more treatment? Did something they give me cause a reaction that has elevated my anxiety past the ability of my meds to deal with it?

 

I don't know what to do anymore. I feel the way I did when I first started having panic attacks 10 years ago and had anticipatory anxiety about the next one, but I don't have any conscious symptoms of fear, just the physical ones.

 

Any insight would be appreciated. All my docs say I'm fine, but I don't feel well. I can't eat and the constant sensations of anxiety are driving me up a wall.

Edited January 16, 2017 by ChessieCat
Added spacing

[ChessieCat]

Hi Kenjamin and welcome to SA,

 

I suggest you put all the drugs in the Drug Interactions Checker and then copy and paste it here as a post.

[Kenjamin]

https://www.drugs.com/interactions-check.php?drug_list=679-0,1464-0,703-357,145-8683,1066-606,1752-1120

 

There's the interaction list. I know zofran is listed as possibly causing serotonin syndrome with citalopram, but my psychiatrist said I would have had to be on zofran for a while for it to cause it. Also, does my situation sound like serotonin syndrome? I can't really tell.

 

All the meds except for the citalopram and klonopin were a once time use in the ER on the morning of the 9th.

[ChessieCat]

A large amount of serotonin is in the gut (about 90%).  Combining the internal and external stresses which you have been under during this time together with the additional drugs you have been given, it would not surprise me if you CNS (central nervous system) is reacting because it has taken a bit of a battering recently.  My personal opinion is that you should Keep it Simple, Slow and Stable as much as possible and be kind to your CNS and give it a chance to recover.

 

These might be helpful:  Maybe try to eat small, regular amounts of easily digestible foods, stay off caffeine drinks, high sugar foods, alcohol.  Keep drugs to what you only need to take.  Try and remain as stress free as possible.  Try and maintain a regular sleep pattern and get plenty of rest.  Mindfulness may be helpful during this time to catch stress before it builds up too much.  When I was going through a high stress time my daughter suggested that I check in with myself during the day to see how I was feeling.  So that I would remember throughout the day I set a timer for an hour, which made me stop and check on myself.  It meant that I was able to nip the stress in the bud and keep it to a minimum.

[Kenjamin]

Thanks for the support. I'm starting to actually feel hungry this evening. I had half of a salad from Subway and am now having two pieces of toast which brings my calories for today above 1000.

 

If I could only feel 100% and still have no desire to eat

 

I'm going to try to work hard to keep the weight off that I lost in the past week despite the circumstances that caused the weight to be lost.