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squirrel

Dizziness, vertigo, light-headedness etc & rocking/swaying/boat

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squirrel

This symptom is really getting me down. I feel unsteady at the best of times but every so often I get intense feelings of dizziness , the floor seems to be moving quickly under my feet i feel so unsteady,I have head pressure and feel nauseous. Dizziness has been a main symptom for me since stopping paroxetine 6 years ago.

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summer

I'm assuming you've had this checked out?? Dizziness can appear for so many reasons.

 

I hope this goes away and you start feeling better very soon!

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Healing

Squirrel, I'm so sorry you're still dealing with this. It's very disheartening to still have such a very debilitating symptom for so long. I really believe it will end, though. It's just taking a very long time.

 

Now, just a question. Am I remembering correctly? Did you get some benefit from the vertigo exercises that were prescribed for you? Is that right? Did they stop helping?

 

Did you see we have a new member -- awalkerphoenix -- who had dizzy spells prior to meds and benefited from exercises given by a physio therapist. Might be worth comparing notes?

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stan

my dear Squirrel, when i read this, i am sad to see how long you suffer from a very debiliting thing,

i will have too some debiliting things, i see and feel it, standing will be a problem for me because today my equilibrium is wrong...

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squirrel

Hi stan my equilibrium is wrong everyday since I stopped the drug and fear that it may never return.

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Altostrata

Acta Otolaryngol. 2010 Sep;130(9):981-3.

A possible explanation for dizziness following SSRI discontinuation.

 

Smith PF, Darlington CL.

 

Source

 

Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, Dunedin, New Zealand. paul.smith@stonebow.otago.ac.nz

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/20144124 Full text at http://www.mediafire.com/?3v4waouysa70j6q

 

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.

Edited by Altostrata
added link to full text

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Altostrata

squirrel, why don't you write the author of this paper and ask him why your dizziness has lasted so long?

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squirrel

Thanks Alto I, May do that.I have tried various others in the past but they have not replied to me. Any Idea how I can read the full article?

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Altostrata

Due to squirrel's diligent searching for this journal article (thank you very much, squirrel), I've posted a link to it above.

 

The paper was published in a journal for otolaryngologists (ear-nose-throat, or ENT, specialists). The authors believe withdrawal dizziness has its origins in the nerves of the inner ear. They are experts on the function of serotonin in the vestibular, or inner ear, system. They are guessing that, since SSRIs increase serotonin, the decrease in serotonin after discontinuation affects these nerves:

 

"....Serotonin has been found in the peripheral vestib- ular system, in the vestibular labyrinth, although its function there is poorly understood (see Smith and Darlington [11] for a review). Serotonin is also known to be an important neurotransmitter in the brainstem vestibular nucleus, which along with the cerebellar ␣occulus, is the only area of the brain to receive direct input from the vestibular nerve carrying vestibular sensory information from the inner ear...."

 

They further suggest that "....the decrease in serotonin may result in the reduced activation of the 5-HT1F receptors, thereby increasing glutamate release by VNC neurons...."

 

But the dizziness could have other causes: "....It is of course possible that dizziness following discontinuation of SSRIs is related to the effects of reduced serotonin in other areas of the brain that are involved in vestibular sensory processing. Vestibular information is transmitted from the VNC to many areas of the limbic system and neocortex via multiple polysynaptic pathways and conceivably any of them could be implicated in the generation of dizziness. However, the high concentration of serotonin receptors in the VNC and the co-localization of the 5-HT1F receptor with glutamate suggest a simpler explanation. Why some patients are affected and others are not, even though they discontinued the same SSRI, is more difficult to explain given our current understanding...."

 

In the conclusion: "....drugs that modulate serotonin and its many receptors, such as tricyclics, monoamine oxidase inhibitors and SSRIs for depression; buspirone for anxiety disorders; ergotamine, the triptans (e.g. sumatriptan), methysergide and pizotifen for migraine; 5-HT3 receptor antagonists (e.g. ondansetron) for nausea and vomiting; and psilocybin, mescaline, lysergic acid diethylamide (LSD) and methylenedioxymethamphetamine (MDMA, i.e. Ecstasy) as recreational drugs, may also affect vestibular function, in some cases predisposing users to blurred vision and falls...."

 

What does this mean, practically, for squirrel? My interpretation is that these doctors believe glutamatergic hyperactivity has taken over in the inner ear to produce this withdrawal symptom -- exactly parallel to our theory of withdrawal syndrome in general.

 

I'm not a doctor, and I don't know how this could be treated. One could print this paper out and take it to a sympathetic otolaryngologist who might craft a treatment. Dr. Smith's e-mail is given above, he might even know of someone you could see.

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squirrel

Thanks I have emailed him so will see what happens.

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Brandy

In the conclusion: "....drugs that modulate serotonin and its many receptors, such as tricyclics, monoamine oxidase inhibitors and SSRIs for depression; buspirone for anxiety disorders; ergotamine, the triptans (e.g. sumatriptan), methysergide and pizotifen for migraine; 5-HT3 receptor antagonists (e.g. ondansetron) for nausea and vomiting; and psilocybin, mescaline, lysergic acid diethylamide (LSD) and methylenedioxymethamphetamine (MDMA, i.e. Ecstasy) as recreational drugs, may also affect vestibular function, in some cases predisposing users to blurred vision and falls...."

 

 

Benzodiazepines are one of the major medication groups to strongly affect dizziness and balance.

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squirrel

can anyone define glutamatergic hyperactivity ? tried to google it but its all doctor talk and I don't understand it.

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Healing

Jeez, serotonin is in the vestibular system. It's in the enamel organs. It's in the GI tract. Is it any wonder we have the cornucopia of w/d symptoms we do? :blink:

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Altostrata

Yep, serotonin is everywhere.

 

can anyone define glutamatergic hyperactivity ? tried to google it but its all doctor talk and I don't understand it.

 

squirrel, read One theory of antidepressant withdrawal syndrome -- does it make it clearer?

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squirrel

yes it does thanks

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squirrel

Been to see balance specialist today. he says I have uncompensated labyrinthitus. I need vestibular physio.he wants me to take cyclizine to calm it down before I start physio. However this is an antihistamine. according to David Healy many anti-histamines'are serotonin reuptake inhibiting

so you might end up back on an SSRI effectively' so what do I do guys??????????

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stan

hi Squirrel,

 

in France they give Betaserc, tanganyl and so on

does this cure : no

and many side-effects with cyclizine (destroy other receptors)

he can make you movements, no need meds first

it is as psychiatrist, they drug you first before speaking why you have agoraphobia

in your case i would never swallow more these craps meds

it is because these meds that you are where you are

 

you can lie ,do as you take them (and throw them away), so he will make you physical movements, and you will see what happens

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Maybe

I see it like Stan. I would never again take any medicine if it were not for saving my life.

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Baxter

Hi, Squirrel,

 

I don't feel like I know enough about drugs to make an informed recommendation. But I am with Stan and Maybe. If you have had problems with antihistimines, and a long, grueling recovery from WD, I'd take the prescription, not fill it and get to the physical therapist as soon as possible.

 

Just my 2 cents.

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Altostrata

This is excellent, squirrel. Did you show anyone the paper about withdrawal and dizziness?

 

I agree with everybody. Try the physical therapy first, tell the docs you are hypersensitive to medications and want to add that as a last resort, you had a severe adverse reaction to an SSRI and are concerned about taking an antihistamine at all.

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squirrel

he would not be interested in the paper, i told him my problems began when I stopped paroxtine, he just said 'thats odd its usually when you start it.' he is very old school I'm afraid.

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Altostrata

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

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squirrel

I am not so sure I agree with his diagnosis last time I saw him he said it was visual vertigo, now its uncompensated labyrinthitusI think Its paroxetine damage! but need to know if it is permanent.

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Baxter

Squirrel, I hope that the PT brings you some relief. In the meantime, the best way to deal with old school docs is act like an old fashioned patient in his presence: deferential, respectful...then do what you damn please with your life. I am staying tuned for the PT results.

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stan

I am not so sure I agree with his diagnosis last time I saw him he said it was visual vertigo, now its uncompensated labyrinthitusI think Its paroxetine damage! but need to know if it is permanent.

 

hi Squirrel,

based on my actual state, i think actually :

the body is not able to heal all the functions (or hormones, or nerves repairing...it is all the same thing)

i think even he heals bad some areas

i would say that an area who function, the body is lost in the chaos and can destroy a part of a function which was well functioning

thinking that the body is able to only heal in the good direction is a mistake

he heals as he can over years better, worse and so on

so you can improve your equilibrium a day but it can last years, it depends from so many factors :genetics,age,health, organs diseases,psychological, time,...)

so "permanent"? nobody has the answer!

so let the body try to heal you slowly , give it more time, do swallow nothing , i do not see another solution for me and you and others sufferer

 

bye!

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Nadia

How do they even diagnose that?

 

I have dizziness as well, and it started in a really weird way. This was before I started getting morning anxiety... I went on a boat for two days, and then when I got off I got "land sickness"... you feel like you are still on the boat (no nausea, just a sensation like things were moving, and affected by my own body movement. Felt better while in movement in a car). I've had it many times in my life before, but usually it goes away in a few hours or a day or two max. This time it lasted months. I heard it happens to people sometimes, that it is not an inner ear thing, but rather something in the brain, and that it can last years. It only affected my balance if I had my eyes closed and leaned forward... just a misstep or two. I went to a doctor to get a checkup and mentioned the dizziness, and she made me stand with my arms extended and my eyes closed. She said I didn't sway, which meant it was not in the cerebellum.

 

Right when it seemed like it was starting to fade, I started getting the anxiety and also was sick to my stomach. Turns out I had amoebas. But now I've been treated for the amoebas and still have the dizziness. The dizziness has mutated, though. Now it's not so much like the outer world is moving, and I do lose my balance more often.

 

My point in all of this explanation is... it is SO COMPLICATED to piece apart causes and effects!! And doctors are so lost! I really have found the best advice and most understanding on this forum. I find most doctors don't really dig to get to the root cause. There are probably some easy cases, and then there are people like us... I feel like a doctor would have to really know you in and out to help you. I went to an ultra-recommended ayurvedic doctor yesterday and even that didn't seem any different. The only difference was he hugged me and asked deep down where I thought my pain and anxiety came from and recommended yoga. Which is fine, but I still felt like I was on a conveyor belt.

 

So hard to find answers.

 

I'm willing to bet our dizziness will go away with time if we just welcome it and let it have its place for the time it needs. I say this, but I also am deeply afraid that it will never go away.

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Nadia

Question: for those of you who are experiencing dizziness, how soon after discontinuing ADs did you notice it creep up? (Or maybe it was sudden?)

 

The study seems to suggest it would be a quick onset due to a sudden discontinuation.

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Altostrata

All the studies on withdrawal syndrome claim symptoms start within a few days, but many of us found more recognizable symptoms started later, sometimes weeks later.

 

The research, such as it is, is not correct in this regard.

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squirrel

My dizziness started a few months after I stopped the drug

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Nadia

That's the problem with so many scientific studies. It's so hard to get funding, most of these are limited to checking effect for weeks after, not months or years. Someday, I hope, more studies will be done. I sent in my "story" to withdrawalcases@gmail.com in the hopes that it might help.

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Punarbhava

Been to see balance specialist today. he says I have uncompensated labyrinthitus. I need vestibular physio.he wants me to take cyclizine to calm it down before I start physio. However this is an antihistamine. according to David Healy many anti-histamines'are serotonin reuptake inhibiting

so you might end up back on an SSRI effectively' so what do I do guys??????????

 

 

David Healey is correct and I would avoid antihistamines. BTW, antihistamines only treat symptoms and thus, do NOT cure the problem. In fact, utilizing such will only confuse your receptors, when ingesting for a few weeks and then ceasing the drug.

 

This will not produce positive long term results. This was also stated in one of the posts I made regarding Ototoxicity (Drugs that Damage the Ears).

 

I agree with others re: follow Stan's suggestion.

 

 

BTW, just to prove that antihistamines target AD WD receptors. When I was tapering from a reinstatement that went horribly wrong, a child's dose of Gravol (dimenhydrinate) had the power to reduce very violent WD symptoms.

 

This proves that antihistamines target receptors that are in AD WD states.

 

 

I learned that I had to avoid that which had the power to help in the short term since, anything that helps will hinder long term recovery, if taken consistently.

 

How are receptors suppose to heal IF they are being regularly doused with another similar chemical? Please read what I have copied and pasted below my signature.

 

I know how difficult this is for you Squirrel and my hope is that the physical therapy will provide beneficial results.

 

 

Much More Healing to You!

 

 

Punar

 

 

Medication for Vestibular Disorders

 

http://www.vestibula.../medication.php

 

The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days) or chronic phase (ongoing). During the acute phase, and when other illnesses have been ruled out, medications that may be prescribed include vestibular suppressants to reduce motion sickness or anti-emetics to reduce nausea.

 

Vestibular suppressants include three general drug classes: anticholinergics, antihistamines, and benzodiazepines. Examples of vestibular suppressants are meclizine and dimenhydinate (antihistamine-anticholinergics) and lorazepam and diazepam (benzodiazepines).

 

Other medications that may be prescribed are steroids (e.g., prednisone), antiviral drugs (e.g., acyclovir), or antibiotics (e.g., amoxicillin) if a middle ear infection is present. If nausea has been severe enough to cause excessive dehydration, intravenous fluids may be given.

 

Symptoms must be actively experienced without interference in order for the brain to adjust, a process called vestibular compensation. Any medication that makes the brain sleepy, including all vestibular suppressants, can slow down or stop the process of compensation.

 

Therefore, they are often not appropriate for long-term use. Physicians generally find that most patients who fail to compensate are either strictly avoiding certain movements, using vestibular suppressants daily, or both.

 

 

VEDA medical advisor Timothy C. Hain, MD, has detailed information about the most commonly prescribed medications that can be a helpful starting point for talking to a physician about the available options.

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squirrel

thank you for this info. Why on earth did balance doc prescribe these pills its his job to know what they do and if it is gonna interfere with physio. Oh boy I really give up on doctors!!!!!!!!!!!

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Punarbhava

thank you for this info. Why on earth did balance doc prescribe these pills its his job to know what they do and if it is gonna interfere with physio. Oh boy I really give up on doctors!!!!!!!!!!!

 

 

They prescribe to alleviate symptoms. This is how they are trained.

 

 

They also know LITTLE about ALL drugs (not just psychotropics). BTW, if a doctor knows nothing about psychotropics then she/he will be prone to prescribing drugs to alleviate psyche drug WD symptoms NOT realizing that such drugs compromised and complicate the integrity to heal from psyche drug WD.

 

Any drug that reduces psyche drug WD symptoms is a drug that is targeting or sharing similar receptor sites.

 

 

Doctors get their info. from pharma reps and many of them don't even read the black box warnings (fine print).

 

 

I don't trust any doctors. Not because there are not some conscientious ones out there but rather, because their knowledge base is EXTREMELY LIMITED. Hence, they can and do cause unintentional harm......... GREAT HARM and when they do, out of their own ignorance, they then label a patient with a psychiatric disorder not realizing that their prescribing practices have made a bad situation even worse.

 

 

I find it quite scary. I will never feel safe in their hands ever again.

 

 

The worse part is that many of them are too damn patriarchal and arrogant to even admit to their own ignorance, even when they are presented with medical and biological facts.

 

BTW, you are right! They SHOULD KNOW but the fact is they don't know, yet they pretend to know it all.

 

I wish you the best with the physical therapy. Hope this provides some relief.

 

 

Punar

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squirrel

thank you. I go for my assessment on wednesday i really hope it works as there is nowhere left to turn.

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Soso

Very interesting, when I went to my chinese doctor she told me that my kidneys are very week that's why I have ear problems.

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squirrel

is there any treatment for that?

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