what is causing adverse reactions to SSRI class of drugs?

[slysaint]

It is widely accepted that some patients with ME/CFS are more sensitive to the adverse
effects of medication than most healthy people.

Not by any GP I've come into contact with

That said; back around 2003 there was a big article in Interaction, the AfME mag, about a number of people who had had ME for many years who were 'cured' by Lustral (Sertraline SSRI) so I asked my GP if I could give it a go.
I wanted to start on really small doses because I was worried about bad reactions so he kindly supplied me with a surgical razor blade to cut the tablets with!
I tried upping the dose but couldn't get anywhere near the 'normal' amount and had to stop.

 

[JES]

I had a severe adverse reaction to one 10mg pill of escitalopram in 2006. It took 2.5 years to feel human again. I continued to improve over the course of 3.5 years but never returned completely to normal or to full time work. At 3.5 years post reaction I suffered an ischenic stroke at age 38 and awoke half paralyzed. That was in 2010. No cause was found and after extensive testing I had no risk factors or causal factors for stroke. I am at 10 years post reaction now and still suffer from amplified sensitivity to many stimuli. I am terribly sensitive to any drug that crosses the blood brain barrier. I am in need of 2 surgeries and cannot tolerate anesthesia or pain medication. The SSRI has ruined my life. I live in fear of needing minor surgery.

Millions of people use SSRI drugs every day, I've yet to read about anyone having such a prolonged reaction from one pill (I've read about permanent sexual dysfunction, but that has built up after a long time on an SSRI). Modern SSRI's like escitalopram have a half-life of less than 24 hours, so the drug would be out of your system within a few days. I have no doubts that you had an adverse reaction, but it seems unlikely a single SSRI pill would cause symptoms 3.5 years later. It's much more likely that other factors are at play during such a long time period.

 

[GreyOwl]

Millions of people use SSRI drugs every day, I've yet to read about anyone having such a prolonged reaction from one pill (I've read about permanent sexual dysfunction, but that has built up after a long time on an SSRI). Modern SSRI's like escitalopram have a half-life of less than 24 hours, so the drug would be out of your system within a few days. I have no doubts that you had an adverse reaction, but it seems unlikely a single SSRI pill would cause symptoms 3.5 years later. It's much more likely that other factors are at play during such a long time period.

Yes, perhaps some metabolic dysfunction induced by the adverse drug reaction? A neuro immune response to the drug? Sounds like the same reason everyone else is here, except substitute "drug" for "virus".

 

[justy]

Nobody could have been more surprised than I was that I developed serotonin syndrome (clinical diagnosis totally solid), given the tiny dose I was on. I had been hesitant to start an antidepressant but reckoned that nothing bad could possibly happen. The other drug I take is ketotifen, an antihistamine (H-1 blocker), so I thought if anything there would be sedating effects. But no, on the contrary.

I know your post is old, but as this thread has been resurrected I thought I would comment on this -antihistamines taken with SSRI's can cause serotonin syndrome. Drs don't tell people this enough.

I had a severe adverse reaction to one 10mg pill of escitalopram in 2006. It took 2.5 years to feel human again. I continued to improve over the course of 3.5 years but never returned completely to normal or to full time work

This is EXACTLY what happened to me - one tablet of citalopram and I was a complete mess. Unfortunately I took a second as my Dr insisted - it took me at least 2 years to be able to sit down and eat a meal or relax and watch TV I was in a living hell and im amazed I didn't take my own life.

Millions of people use SSRI drugs every day, I've yet to read about anyone having such a prolonged reaction from one pill

Well now you have read about two of us! It does happen. I took two pills and was thrown from mild anxiety symptoms and fatigue (I actually had Lyme disease and undiagnosed M.E) into two years of a living hell. as stated above I had severe akasthesia that lasted for at least two years. It was literally unbearable. I have read on the internet of many people having similar experiences, that have become prolonged. It is NOT abnormal in PWME to have these kinds of abnormal reactions to SSRI drugs.

Modern SSRI's like escitalopram have a half-life of less than 24 hours, so the drug would be out of your system within a few days

That's what my GP told me - it took over two years until I began to feel halfway normal again - and the anti D's had been wrongly prescribed. GP's ignorance over ME can cause a lot of damage.

it seems unlikely a single SSRI pill would cause symptoms 3.5 years later. It's much more likely that other factors are at play during such a long time period.

As I said, same thing happened to me, exact same experience. My experience and others tells me this IS possible.

 

[justy]

indeed it can
http://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments

Unfortuantely my GP said it was 'just side effects of the med and will settle down if I keep taking it' - after that they lost interest - no official diagnosis of serotonin syndrome or akasthesia. They then gave me a dx of agoraphobia and severe anxiety disorder - but I didn't have these things before that one dose of Celexa.

 

[Living Dead]

SSRIs alter/lower the production of NO (nitric oxide), which is already a problem area (either too much or too little) in ME.

Serotonin also appears to exert direct effects on sexual organs by decreasing sensation and by inhibiting nitric oxide

http://asp.cumc.columbia.edu/psych/asktheexperts/ask_the_experts_inquiry.asp?SI=226

http://asserttrue.blogspot.no/2013/03/nitric-oxide-antidepressants-and-sexual.html

 

[me/cfs 27931]

Unfortuantely my GP said it was 'just side effects of the med and will settle down if I keep taking it' - after that they lost interest - no official diagnosis of serotonin syndrome or akasthesia. They then gave me a dx of agoraphobia and severe anxiety disorder - but I didn't have these things before that one dose of Celexa.

I've had bad psych med reactions over the decades, but not to the SSRI class of drugs (Celexa, Prozac, Paxil, Zoloft... off the top of my head). Well, Paxil did give me bad insomnia for a couple weeks.

But the SSRI's really didn't help much either.

When ME/CFS was in remission, doctors would say "look the drug is working". And when I relapsed on the same drug, psychiatrists would call it "poop out" and say the drug just stop being effective.

That way they couldn't be wrong.

For example, I took Zoloft 200mg/day for more than 3 years (1991-1994) during a remission and stopped it to try another drug during a relapse because it wasn't helping ("poop out").

In retrospect, I don't think SSRIs did anything positive or negative for my varied neuro symptoms, PEM, fatigue, or anxiety. It's all better explained by my normal 2-4 years relapse/remit ME/CFS disease cycle.

SSRIs did slightly help my secondary depression during relapse. But getting correctly diagnosed with ME/CFS and learning how to pace has helped my secondary depression more than any SSRI ever did.

 

[JES]

indeed it can
http://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments


yes it can and certainly has for me on more than one occasion.

Serotonin syndrome is something acute but short lived, I experienced symptoms of it as well when I took an SSRI and combined it with another serotonin promoting supplement, such as large dose Vitamin B6. It can be deadly in worst case, but it's not something that goes on for years after you take one pill.

I wouldn't say an SSRI cannot cause damage to CFS patients (though I don't understand why it would improve after 2 years), in fact it's possible that standard medications like SSRI's cause a very different reaction to normal in a severely sick body like that of a CFS/ME patients. All my last post was questioning was that a singe SSRI pill would ruin the life of a person who gave the impression he was previously healthy and not suffering from CFS/ME. CFS/ME is a result of multiple abnormalities and you wouldn't "catch" it by taking a single SSRI pill.

 

[slysaint]

GP's ignorance over ME can cause a lot of damage.

to clarify also: this is what I was referring to when I said yes it can and it has happened to me on more than one occasion.
I have had adverse reactions to a number of 'safe' medications but the GPs generally refused to accept it being connected to having ME. In fact, having bought a copy of my medical records, it just says I had CFS (they wont't call it ME anymore) in 2001 and doesn't flag it up as an ongoing condition.

 

[justy]

But getting correctly diagnosed with ME/CFS and learning how to pace has helped my secondary depression more than any SSRI ever did

Having a diagnosis of M.E and understanding what that meant helped my severe anxiety. If you have moderate M.E and are told there is nothing physically wrong with you and carry on pushing through for example trying to go out walking for long walks with the dog or driving long distances, shopping in the supermarket alone etc then anyone would feel horribly anxious all the time as your body is screaming out to lay down and rest! once I had the ME dx the and started resting the anxiety gradually declined.

All my last post was questioning was that a singe SSRI pill would ruin the life of a person who gave the impression he was previously healthy and not suffering from CFS/ME. CFS/ME is a result of multiple abnormalities and you wouldn't "catch" it by taking a single SSRI pill.

I don't think either of us who had this experience are suggesting we 'caught' M.E from taking one dose of an SSRI. For me it was very complex - I already had M.E, undiagnosed for 14 years. I was in what I now know was a long remission to near normal. What actually was happening was that I was having a severe M.E relapse - but never having the dx before I didn't know what this was - the same old symptoms of not being able to physically cope came up and the anxiety started to kick back in a little. Fearing a return to the 'illness' I had previously had, that my GPs at the time has dubbed 'psychological' I eagerly took the anti D thinking it would stop the descent back into ill health I had had before and that they had convinced me years earlier was all in my mind. I beleieved them, took the drug and descended into a hell that did last for at least two years.

I find your tone of your post a little offensive as you seem to be questioning peoples experiences. we have enough of that from the Drs. I tell you, it is a fact that I was in a mild M.E relapse - didn't know that's what it was because it took me 17 years to get a diagnosis - took one SSRI, then the next day another against my own better judgment - egged on by Drs and descended into a literal hell that last years. I had severe akasthesia that meant couldn't sit down, eat, sleep or rest. I lost two stone in weight in just one month. I couldn't speak to my children or sit at the table with them for about 6 months as the agitation was so intense. I couldn't bear to be alone as I thought I was literally going insane. I cried every time I was alone and became hysterical due to the agitation the SSRI caused.

You can just imagine how great this was for my ME, which is now, 7 years later, severe. If I had had the correct help back then I may never have ended up this ill. The Drs didn't believe me that two doses of an SSRI could make anyone this severely ill with anxiety etc, but I tell you it did and it did last at least 2 years and has left permanent psychological scarring.

 

[Justin30]

One SSRI was terrible for me. If you read about dome SSRIs and ME they can have very megative consequences. CFS a Treatment Guide 2nd addition book will highlight what certain Drd have said. I will not take them other then Rameron for sleep.

Venafalaxine was terrible for me and I only took 1 pill and was messed up for weeks.

Then I baught the book and read about the potentail negative reactions in some people with ME.

 

[Cubbies2016]

Hello,

I had an adverse reaction to Lexapro that triggered all kinds of stress, panic (emotions located in the hypothalamus) and head pain. When the stress left it left my body in a fatigued state. My endo labs dropped to low range. Low cortisol and magnesium (though I supplement regularly). Sleep is poor and non restorative. I read that the orexin neurons are part of the mitochondrial and hypothalamus and control energy and sleep. Adverse reactions can interfere with it and start a mitochondrial disaster. If anyone else shared a similar story, I would like to hear about it.

http://www.drcourtneycraig.com/blog/2014/11/29/medication-induced-mitochondrial-damage

 

[wdtony]

Hello,

I had an adverse reaction to Lexapro that triggered all kinds of stress, panic (emotions located in the hypothalamus) and head pain. When the stress left it left my body in a fatigued state. My endo labs dropped to low range. Low cortisol and magnesium (though I supplement regularly). Sleep is poor and non restorative. I read that the orexin neurons are part of the mitochondrial and hypothalamus and control energy and sleep. Adverse reactions can interfere with it and start a mitochondrial disaster. If anyone else shared a similar story, I would like to hear about it.

http://www.drcourtneycraig.com/blog/2014/11/29/medication-induced-mitochondrial-damage

Yes, I experienced a horrible reaction to 1 dose of Lexapro. 10 years ago. Now I cannot tolerate most drugs that cross the blood brain barrier.

 

[wdtony]

I know your post is old, but as this thread has been resurrected I thought I would comment on this -antihistamines taken with SSRI's can cause serotonin syndrome. Drs don't tell people this enough.



This is EXACTLY what happened to me - one tablet of citalopram and I was a complete mess. Unfortunately I took a second as my Dr insisted - it took me at least 2 years to be able to sit down and eat a meal or relax and watch TV I was in a living hell and im amazed I didn't take my own life.



Well now you have read about two of us! It does happen. I took two pills and was thrown from mild anxiety symptoms and fatigue (I actually had Lyme disease and undiagnosed M.E) into two years of a living hell. as stated above I had severe akasthesia that lasted for at least two years. It was literally unbearable. I have read on the internet of many people having similar experiences, that have become prolonged. It is NOT abnormal in PWME to have these kinds of abnormal reactions to SSRI drugs.



That's what my GP told me - it took over two years until I began to feel halfway normal again - and the anti D's had been wrongly prescribed. GP's ignorance over ME can cause a lot of damage.


As I said, same thing happened to me, exact same experience. My experience and others tells me this IS possible.

I took only one dose of Lexapro and it took 2.5 years to feel half-human again. The SSRI might be out of your system within a few days but the damage can last for weeks or even years.

Also, I had been taking guafinesin (an antihistamine) during the time I took the Lexapro.... could this have exacerbated the adverse reaction I had?

 

[justy]

I took only one dose of Lexapro and it took 2.5 years to feel half-human again. The SSRI might be out of your system within a few days but the damage can last for weeks or even years.

Also, I had been taking guafinesin (an antihistamine) during the time I took the Lexapro.... could this have exacerbated the adverse reaction I had?

I really don't know - I wasn't taking any other drugs when this happened to me. Im sorry you had to go through this too.

 

[harveythecat]

I've just taken my first SSRI pill ever today - my doc said it was a low dose. At first I felt really sick for a short while and now I feel weirdly high. After reading this thread I'm worried about continuing

 

[Snow Leopard]

I've just taken my first SSRI pill ever today - my doc said it was a low dose. At first I felt really sick for a short while and now I feel weirdly high. After reading this thread I'm worried about continuing

Yes, sometimes ignorance is bliss!

I'd say try not to let this thread influence you, but the cat is out of the bag.

Some people with ME tolerate them fine, with no substantial side effects. So it might not be a problem.

That said, personally I'd only ever consider taking MAOI class antidepressants for depression...

 

[Judee]

Something that can help with serotonin syndrome is the antihistamine periactin, which has anti-serotonin effects that can help with serotonin syndrome.

Very old thread but I think I saw somewhere here recently in some study that was being quoted that they are truly finding pwME do have too much serotonin in our brains. Would this be something to help even for someone not on an SSRI?

And if anyone knows the study I mean, could you post it as well? Thank you.

 

[pattismith]

Very old thread but I think I saw somewhere here recently in some study that was being quoted that they are truly finding pwME do have too much serotonin in our brains. Would this be something to help even for someone not on an SSRI?

And if anyone knows the study I mean, could you post it as well? Thank you.

I think too much serotonin in the brain was the hypothesis of HTESTER in the IDO theory.
However I don't tolerate well antidepressant and found it could match with this theory

https://forums.phoenixrising.me/thr...apathy-lack-of-motivation.86924/#post-2430050
...

 

[heapsreal]

Very old thread but I think I saw somewhere here recently in some study that was being quoted that they are truly finding pwME do have too much serotonin in our brains. Would this be something to help even for someone not on an SSRI?

And if anyone knows the study I mean, could you post it as well? Thank you.

Maybe with ssri's our brain can't regulate the amount properly as I've never been able to tolerate a proper normal dose but a half or quarter dose I can sort of tolerate but usually I still have insomnia from them.

The supplement 5htp, which supposedly increases serotonin and seems easy to tolerate for me. Maybe it's easier for my brain to regulate the amount it turns into serotonin.

Another thing I've found interesting is tramadol, which is actually an snri type of substance as well as synthetic opiate effects. I seem to tolerate it fine, which I think is probably because of its short half life. But if I take it at night, I can't sleep, so I don't take it too late in the day. When I first started using tramadol, it had a good antidepressant effect, outside of its pain relieving effects. Now I don't really notice this effect as probably have a tolerance to the snri effects of it. But it keeps working well for chronic lower back pain, although does nothing for other pain like headaches/migraines.

Also, a few years back I used tryptophan for insomnia at 3000mg an hour before sleep and it worked OK. I did notice the next day I felt quite Good mood wise, which I think was the increase in serotonin. I think the tryptophan worked better than 5htp but tryptophan has to be timed better ie a few hrs away from any protein meals, where 5htp supposedly you don't. Tryptophan I don't know why, but is expensive for a supplement especially at 3000mg a day.

That's my experience with serotonin.