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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by PeterJ on June 11, 2000, at 3:04:01
Has anyone experienced akinesia (slowness or absence of
movment) as a result of SSRIs.I am currently taking Celexa (citalopram). I was doing
all right until the third week, when we raised the dose
to 20mg. At that point I experienced difficulty
in moving. It was hard for me to get moving and my
movements felt abnormally slowed. I would spend up to
an hour or two at a time sitting almost stock-still
in my chair. When I was able to move it took effort
and I would do so slowly and stiffly.I have continued the medication in hope this would pass.
It is getting a bit better--or I wouldn't be able to
type this post--but I still feel significantly
slowed and stiff two weeks later.This is different from sedation or fatigue or
depression. It's definitely a slowed down feeling.
My limbs feel stiff and slow. My mind is also a bit
slowed, but it is relatively clear and not sedated.
There is no tremor, although there are sometimes
brief periods of restlessness.I have seen reports of akinesia in Parkinsons patients
given SSRIs, but I don't have Parkinsons.I experienced a similar effect on an MAOI and on
trazodone. In the case of trazodone the onset also
occurred suddenly at three weeks. What is most
worrying is that with these drugs, especially trazodone,
it took a long time for the effect to go away even
after I stopped the drug. It was at least two months
before I was back to normal.The only other SSRI I have tried was fluoxetine, and
I was never able to reach a therapeutic dose due
to severe agitation on 1mg a day.Biochemically I think I am dealing with a serotonergic
inhibition of dopamine function in the basal ganglia
mediated via 5HT2 receptors.
The 3 week delay is probably due to the time needed to
down regulate auto-inhibitory 5-HT1A receptors.I would like to try this medication for a full 6 to
8 weeks or more, but the onset of this effect is rather
worrying.I will be discussing with my doctor whether it is worth
continuing this drug. We had high hopes for it, so
I don't want to give up, but this seems like a serious
side effect.What I'd like to ask the Babble community is, have
any of you experienced this kind of side effect on
Celexa or any other SSRI? What was the outcome?Thank you,
Peter
Posted by JohnL on June 11, 2000, at 4:39:21
In reply to Akinesia (slow moving) on SSRIs (Celexa), posted by PeterJ on June 11, 2000, at 3:04:01
Peter,I might be over reacting. But I personally wouldn't--no way, no how--stay with any medication that did to me what Celexa is doing to you. I mean, I've been on so many medications and I'm no stranger to side effects. But that particular kind of side effect sounds scary to me.
As to the technical biochemical cause of the depression--5HT2, basal ganglia, etc--well, that's beyond my knowledge. So I can't comment one way or the other. But I do feel that theories similar to that aren't all that helpful. What is more helpful to me is to utilize clues from medication reactions to steer us in a direction toward a more appropriate medication. Results are all that matter in my world. We all have different ways of looking at these things, and I don't think there are any rights or wrongs.
The end result is all that matters to me. Based on your body's reaction so far to Celexa, Prozac, and Traz, it seems to me better results might be waiting in a different class of medication. There's something funky going on in your case that these serotonin meds are influencing in an undesirable--and scary--way. I don't know, maybe I'm over reacting.
JohnL
Posted by SLS on June 11, 2000, at 9:30:19
In reply to Akinesia (slow moving) on SSRIs (Celexa), posted by PeterJ on June 11, 2000, at 3:04:01
Dear Peter,
There is too much here for me to read, but I guess you have already considered the possibly analogous observations that SSRIs have produced akithesia infrequently in people being treated for depression, presumably 5-HT2 mediated. I don't recall any mention of comorbitity with schizoid disorders in these cases.
It would look as if your explanation of the latency of onset of this syndrome makes sense. Perhaps you have managed to uncover an idiosynchratic 5-HT2 receptor polymorphism that might account for differences in your neurobiological constitution and your paradoxical reactions to other drugs. Wild guess. Sorry.
Had you been receiving any benefit from Celexa otherwise?
Good luck. Difficult choice.
- Scott
Posted by Anna P. on June 11, 2000, at 17:37:57
In reply to Akinesia (slow moving) on SSRIs (Celexa), posted by PeterJ on June 11, 2000, at 3:04:01
> Has anyone experienced akinesia (slowness or absence of
> movment) as a result of SSRIs.
>
> Yes, I've experienced this with Tianeptine. It looks like Celexa is doing that to you.
When I took Amineptine, it reversed the problem.
But..., the long use of antidepressants causes the heart pain in me. The only drug without the cardiac effect for me is Tianeptine.
I'm helpless for now...Anna P.
Posted by PeterJ on June 15, 2000, at 4:20:21
In reply to Akinesia (slow moving) on SSRIs (Celexa), posted by PeterJ on June 11, 2000, at 3:04:01
Thanks everyone who responded to this thread.I talked to my doctor on Monday and we decided to
stop the Celexa.The akinesia has diminished a bit, but based on my
past experience it may take many weeks until it
disappears completely.The bright side is that I think my response may
provide some clues pointing towards other drugs
that may be more helpful to me.Peter
This is the end of the thread.
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