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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Red_Rach on March 6, 2006, at 15:51:48
Just over 2 weeks ago I stopped prozac and started Celexa at 20mg. On Sunday I increased the Celexa to 40mg. Since increasing the celexa I have been having very vivid and strange dreams, I have also had 2 episodes of what I think is sleep paralysis. The first time while having a vivid dream I became aware of an inability to move or speak, this feeling wore of and I continued to sleep. Tonight I had another episode, except I woke up. Upon waking I couldnt move or speak, and felt very strange. I was trying to shout and bang for help but was unable to, I began to panic. Eventually I was able to move as normal.
Could this be caused by the increase in Celexa?
Its a very frightening experience and the dreams are concerning.
Posted by nolvas on March 6, 2006, at 15:51:49
In reply to SSRI Causing Sleep paralysis?, posted by Red_Rach on March 1, 2006, at 20:30:38
I haven't found anything that suggests sleep paralysis as a side effect of Celexa or any other SSRI. I have found this where some one is having sleep paralysis when stopping Celexa >
http://www.drugs.com/forum/topic.asp?TOPIC_ID=15679
However it doesn't mean that the Celexa isn't at fault in your case. I would speak to your doc and tell him about the sleep paralysis and your history of sleep paralysis i.e some or none and it only has started since you changed meds and upped the dosage.
Posted by Red_Rach on March 6, 2006, at 15:51:49
In reply to Re: SSRI Causing Sleep paralysis?, posted by nolvas on March 2, 2006, at 3:37:09
I am due to see my doctor shortly and will mention this. For now Ive reduced the dose back to 20mg to see if this stops the vivid dreams, obviously if it has no effect I will consider prozac withdrawl, I did stop it abruptly. Im willing to try anything to calm my OCD, but the dreams were getting a bit concerning, the sleep paralysis was the cherry on the cake!
Thanks for replying
Posted by TylerJ on March 6, 2006, at 15:51:49
In reply to SSRI Causing Sleep paralysis?, posted by Red_Rach on March 1, 2006, at 20:30:38
> Just over 2 weeks ago I stopped prozac and started Celexa at 20mg. On Sunday I increased the Celexa to 40mg. Since increasing the celexa I have been having very vivid and strange dreams, I have also had 2 episodes of what I think is sleep paralysis. The first time while having a vivid dream I became aware of an inability to move or speak, this feeling wore of and I continued to sleep. Tonight I had another episode, except I woke up. Upon waking I couldnt move or speak, and felt very strange. I was trying to shout and bang for help but was unable to, I began to panic. Eventually I was able to move as normal.
>
> Could this be caused by the increase in Celexa?
>
> Its a very frightening experience and the dreams are concerning.I had the same type of dreams when i was on remeron...I hated them so bad sometimes i was afraid to go to sleep. They are truly very disturbing!
Tyler
Posted by ed_uk on March 7, 2006, at 15:29:15
In reply to SSRI Causing Sleep paralysis?, posted by Red_Rach on March 1, 2006, at 20:30:38
Hi
Sleep paralysis and vivid dreams are withdrawal symptoms. Fluoxetine (Prozac) has a long half life, the withdrawal symptoms can take a couple of weeks to 'kick in'. Increasing your citalopram dose should help. Do I rememeber that you were taking a high dose of fluoxetine? 40mg citalopram (Cipramil, Celexa) is not enough to substitute for a high dose of fluoxetine.
Btw, I take 80mg citalopram myself.
Kind regards
Ed
Posted by ed_uk on March 7, 2006, at 15:34:12
In reply to Re: SSRI Causing Sleep paralysis?, posted by nolvas on March 2, 2006, at 3:37:09
IMO, 40mg citalopram may be approximately 'equivalent' to 20mg fluoxetine. You may need a lot of citalopram to substitute for 80mg fluoxetine. Taking the citalopram at night would be a good idea. The maximum recommended dose of citalopram is 60mg per day, although this restriction is not based on any good evidence, higher doses may be used if necessary......and if your doc will prescribe........although it is unlikely that citalopram will be any more effective than fluoxetine.
Ed
Posted by TylerJ on March 7, 2006, at 16:12:37
In reply to Re: SSRI Causing Sleep paralysis?, posted by ed_uk on March 7, 2006, at 15:29:15
> Hi
>
> Sleep paralysis and vivid dreams are withdrawal symptoms. Fluoxetine (Prozac) has a long half life, the withdrawal symptoms can take a couple of weeks to 'kick in'. Increasing your citalopram dose should help. Do I rememeber that you were taking a high dose of fluoxetine? 40mg citalopram (Cipramil, Celexa) is not enough to substitute for a high dose of fluoxetine.
>
> Btw, I take 80mg citalopram myself.
>
> Kind regards
>
> EdEd,
I really experience sleep paralysis while I was taking Remeron. They are really frightening..I hated them! This was the only thing I hated about Remeron. Since I've been off remeron I have not had one Paralysis dream.Take care, Tyler
Posted by ed_uk on March 7, 2006, at 16:50:58
In reply to Re: SSRI Causing Sleep paralysis? » ed_uk, posted by TylerJ on March 7, 2006, at 16:12:37
Hi Tyler :)
Sorry for the confusion, my post above was to Red_Rach. When I said 'sleep paralysis and vivid dreams are withdrawal symptoms', I was referring to her symptoms, not yours.
It does not surprise me that Remeron caused sleep paralysis. Remeron alters sleep architecture in a way which might be expected to make sleep paralysis more likely.
Kind regards
Ed
Posted by TylerJ on March 7, 2006, at 17:02:26
In reply to Re: SSRI Causing Sleep paralysis? » TylerJ, posted by ed_uk on March 7, 2006, at 16:50:58
> Hi Tyler :)
>
> Sorry for the confusion, my post above was to Red_Rach. When I said 'sleep paralysis and vivid dreams are withdrawal symptoms', I was referring to her symptoms, not yours.
>
> It does not surprise me that Remeron caused sleep paralysis. Remeron alters sleep architecture in a way which might be expected to make sleep paralysis more likely.
>
> Kind regards
>
> EdGotcha..Thanks Ed.
Tyler
P.S. could you please check out my post below on Trazodone...I value your opinion.
Posted by spriggy on March 8, 2006, at 0:17:23
In reply to Re: SSRI Causing Sleep paralysis? » ed_uk, posted by TylerJ on March 7, 2006, at 17:02:26
I had ONE experience with sleep paralysis; it was SOO frightening. I could see and hear everything around me but couldn't move or speak; even though I tried. I finally was able to "grunt" and then that allowed to move.
Oddly enough, this happened not long after my Lexapro withdrawal.
Posted by River1924 on March 8, 2006, at 3:36:42
In reply to SSRI Causing Sleep paralysis?, posted by Red_Rach on March 1, 2006, at 20:30:38
http://en.wikipedia.org/wiki/Hypnogogia
http://encyclopedia.thefreedictionary.com/narcolepsyI don't know why you are taking celexa but you migh find these articles interesting and they many apply to you.
Good Luck. River.
Posted by tizza on March 10, 2006, at 18:44:25
In reply to Hypnopompia? » Red_Rach, posted by River1924 on March 8, 2006, at 3:36:42
interesting River, I have suffered from this since I was about 4, sleep paralysis, excessive daytime sleepiness, terrible nightmares that continue into my bedroom and I can't move but not narcalepsy. I have just become use to it. Paul.
Posted by River1924 on March 11, 2006, at 0:46:27
In reply to Re: Hypnopompia? » River1924, posted by tizza on March 10, 2006, at 18:44:25
hi paul,
I doubt if it is of any signifigance to you but I have EDS (excessive daytime sleepiness.) For me, I just considered it a symptom of my atypical depression. It improved a great deal after I was tested for a fairly common genetic disorder called hemochromatosis. (One in 200 have the gene and one in 1000 need treatment. My body tends to absord too much iron and store it as a protein called ferritin.)
Anyway, I have sleep apnea and I needed a sleep test so insurance would pay for a new machine.
I was quite suprised when the doctor casually remarked that I have narcolepsy. I thought of (and still think of narcolepsy) as sleep attacks and cataplexy. I guess other symptoms include those you have and just live with...
Oddly, I only have EDS but that qualifies me for a diagnosis of narcolepsy. I found that odd. I take provigil and stimulants. (If I didn't I would sleep alot but I am capable of keeping myself awake if necessary.)
So, if you saw my sleep doctor, he would say you have narcolepsy. For me, it seems like an abuse of language. It makes the term so loose as to be meaningless.
A friend of mine had horrible nightmares and sleep paralysis. She also had strange rather peculiar experiences involving ghosts boys who wrote messages in her bathroom mirror. As well as many other odd psychic experience and months of constnat deja vu. She had such bad insomnia that I don't think she knew she was dreaming. (I didn't either at the time. I was open to what she said because she was an honest and normal person. Now I think I would tell her she had some sort of REM sleep disorder.)
I could accept my diagnosis of narcolepsy if I had symptoms such as yours. It would suggest that I dropped into REM states easily and that my body would be paralysed as if I was in a REM state even when I was awake... but I hardly ever dream and have never had sleep or wake paralysis.
Well, there really is no point to this ramble but narcolepsy may not mean what you, I and most people assume it means. It encompasses many symptoms and even one of them can get one the diagnosis. Why would you want the diagnosis? I suppose if my friend had had the right treatment... meds might have been able to suppress her REM sleep so she did not dream month after month about vampires dragging her underground with the heads of all her friends and family stuck on spikes and burning. Do any meds reduce your dreams or sleep paralysis? Do you take anything for EDS?
Well, I've taken a lot of your time. Good health! River.
Posted by tizza on March 11, 2006, at 1:37:42
In reply to the MD casually remarked that I have narcolepsy » tizza, posted by River1924 on March 11, 2006, at 0:46:27
that was quite a remarkable post river, I have been tested for hemochromatosis because it runs in my family and my test results were negative. I'm pretty sure I have sleep apnea but an old friend of mine said don't bother getting check for it, he works at a sleep clinic, anyway night paralysis has become part of my life and I have found that if I don't fight it I wake up reasonable ok. When I used to fight it I would be exhausted for days afterwards. Babble mail me if you would like to discuss this further, I'd love to hear from you. Paul. There is so much more to talk about but I'm too tired at the moment.
Posted by zeugma on March 11, 2006, at 6:32:24
In reply to Re: Hypnopompia? » River1924, posted by tizza on March 10, 2006, at 18:44:25
> interesting River, I have suffered from this since I was about 4, sleep paralysis, excessive daytime sleepiness, terrible nightmares that continue into my bedroom and I can't move but not narcalepsy. I have just become use to it. Paul.>>
The drugs that block sleep paralysis and excessive REM are tricyclics, MAOI's, and last and least, SSRI's (this last class of drugs actually causes REM behavior disorder at a rate far higher than any other class of psychotropic med). Unfortunately, I cannot become used to it, because I do not merely experience visual, but also tactile hallucinations, intense pain that shoots my body and makes me feels as though I had fallen asleep in an electric chair. My REM latency, unmedicated, is zero- in fact on my current mix of meds (Provigil for EDS and ADHD, clonazepam for extreme social anxiety, and nortriptyline, an old TCA, for REM blockade and depression, with buspirone, a poor anxiolytic but with antidepressant properties, for additional REM blockade-)
staying awake is essential for me on this mix. Provigil does not block REM, so it actually makes me more vulnerable to sleep paralysis hypnagogic hallucinations etc. The first day I took clonazepam, I went immediately into REM when I fell asleep (so I know that clonazepam alters sleep architecture in some way that collapses sleep stages 1-4, leading to easier entry into REM).So I take lots of caffeine, that helps the general fog, and I try to avoid excessive emotion (that is a well known trigger for cataplexy, and I believe that corticosterone increases REM pressure, and corticosterone is released during stress), but avoidance of excessive emotion, although it is the reason I relentlessly analyze every stimulus I encounter in order to drain it as much as possible of emotional significance in order to avoid increasing the REM pressure (a tactic I intuitively adopted when faced with increased hallucinations/paralysis when stressed) is not really possible in this world.
-z
Posted by tizza on March 11, 2006, at 7:17:14
In reply to Re: Hypnopompia?, posted by zeugma on March 11, 2006, at 6:32:24
*Unfortunately, I cannot become used to it, because I do not merely experience visual, but also tactile hallucinations, intense pain that shoots my body and makes me feels as though I had fallen asleep in an electric chair.*
z I have suffered from this for years, I must admit that it is not so bad when I have taken TCA'S, SSRI's or SNRI's but I'd rather go through the motions of it than the terrible side effects that I suffer from AD's. The tactile hallucinations are probably the worst (as in the freakiest) but I have learnt to deal with them. It sucks but I'm so much happier for being off the major med-go-round. Benzo's seem to be the most beneficitial for me. Please feel free to babble-mail me if you know more about this, I'd love to hear more from you, Paul.
Posted by tessellated on March 11, 2006, at 7:43:08
In reply to Re: Hypnopompia?, posted by tizza on March 11, 2006, at 7:17:14
had hypnogogia since childhood.
enhanced early with desipramine at age 12.i can almost overide all the fear instincts.
but it is seriously impossible to differentiate hallucinations from reality. i use my kitty cat as an objective reference. if she's sleeping soundly i know its all in my mind.interesting to hear how much this is a biproduct of AD therapy.
These liminal states are pretty deep, and have a lot of precedent in eastern philosophy....
Posted by SLS on March 11, 2006, at 8:02:38
In reply to Re: Hypnopompia?, posted by zeugma on March 11, 2006, at 6:32:24
> my current mix of meds (Provigil for EDS and ADHD, clonazepam for extreme social anxiety, and nortriptyline, an old TCA, for REM blockade and depression, with buspirone, a poor anxiolytic but with antidepressant properties, for additional REM blockade-)
What about throwing Parnate in there to suppress REM? It should be safe with the drugs you are currently taking. I don't see any serotonergic drugs there.
- Scott
Posted by tizza on March 11, 2006, at 8:27:31
In reply to Re: Hypnopompia?, posted by SLS on March 11, 2006, at 8:02:38
> > my current mix of meds (Provigil for EDS and ADHD, clonazepam for extreme social anxiety, and nortriptyline, an old TCA, for REM blockade and depression, with buspirone, a poor anxiolytic but with antidepressant properties, for additional REM blockade-)
>
> What about throwing Parnate in there to suppress REM? It should be safe with the drugs you are currently taking. I don't see any serotonergic drugs there.
>
>
> - ScottScott, I'm still amazed at how much you guys know. It blows me away. If I had these resources at my finger tips 12 years ago, I don't think I would have taken anything except benzo's. Paul
Posted by ed_uk on March 11, 2006, at 12:52:21
In reply to Re: Hypnopompia?, posted by zeugma on March 11, 2006, at 6:32:24
Hi Z
I was under the impression than most benzos reduce REM sleep. How do you feel about trying a different benzo?
Regards
Ed
Posted by SLS on March 11, 2006, at 13:15:40
In reply to Re: Hypnopompia? » zeugma, posted by ed_uk on March 11, 2006, at 12:52:21
> I was under the impression than most benzos reduce REM sleep. How do you feel about trying a different benzo?
Or what about trimipramine to improve sleep architecture?
- Scott
This is the end of the thread.
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