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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Prefect on September 23, 2012, at 10:31:19
-On 50 mg Luvox for 7 years for agoraphobia and panic disorder
-6 months ago began tapering down very slowly
-Relapsed last month after reaching 37.5 mg!
-Reinstated original dose
-Now I have involuntary muscle jerks just as I'm about to fall asleep, which jolt me awake, causing couple of hours of insomnia some nights. Also day time moments of odd feelings of tension mixed with slight mania/rage (lasts a couple of seconds at a time).
Question: How can I have a side effect like this going back on the same dosage of a med I'd been on for 7 years without these side effects?!
Posted by SLS on September 23, 2012, at 11:56:33
In reply to Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 23, 2012, at 10:31:19
> -On 50 mg Luvox for 7 years for agoraphobia and panic disorder
>
> -6 months ago began tapering down very slowly
>
> -Relapsed last month after reaching 37.5 mg!
>
> -Reinstated original dose
>
> -Now I have involuntary muscle jerks just as I'm about to fall asleep, which jolt me awake, causing couple of hours of insomnia some nights. Also day time moments of odd feelings of tension mixed with slight mania/rage (lasts a couple of seconds at a time).
>
> Question: How can I have a side effect like this going back on the same dosage of a med I'd been on for 7 years without these side effects?!
>For how long have you had the side effects?
Did you have these side effects appear the first time Luvox was introduced?
Have your psychiatric symptoms lessened?
It would take a pretty smart neuroscientist to answer your question. However, weird things happen all the time with psychotropic drugs. The brain is not a static mechanism. It is plastic and dynamic. It reacts to change. Your changing the dosage of Luvox down and then up again probably elicited a sensitization reaction in a manner similar to how one reacts more strongly to cocaine after the brain is exposed to it a few times. Serotonin receptors may have had the opportunity to upregulate while at the lower dosage and are now resistant to downregulation. Things are usually not that simple, though. It could involve postsynaptic second messenger signalling. I really don't know.
Either way, I doubt that you are imagining these things. They might eventually disappear, but it can take some time.
- Scott
Posted by phillipa on September 23, 2012, at 15:16:50
In reply to Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 23, 2012, at 10:31:19
Looks like I won't be decresing my 50mg of luvox any time soon. One time about 6 years ago a doc wanted to see a baseline cold turkeyed per his instructions and even with the addition of can you believe 6mg of time release xanax no sleep, then after a week he put me on 8mg of ativan. ER docs as two weeks and no sleep. Didn't understand said to resume normal luvox and go back on valium. That night I slept. Was taking 15 mg of luvox then. What if you raise the dose to 75mg as I saw in achieves I once did this. When went back to 50mg I don't think had any problems? I'm so sorry Phillipa
Posted by Prefect on September 23, 2012, at 18:52:17
In reply to Re: Reinstated Luvox dosage causing new side effects?! » Prefect, posted by SLS on September 23, 2012, at 11:56:33
I've been back on 50 mg about a month, and the jerking awake problem has been going on a couple of weeks, though it doesn't happen every night.
This never happened before, either fist time taking Luvox, or first time I dosed up to 50 mg.
As for my psychological problems, they're there, but the Luvox gives me the mental advantage to fight off the anxiety better. The last time it took a long time (a year?) for me to feel normal going anywhere, and I suspect the same will apply now. But when I was on 37.5 mg I felt like at times I was on the verge of losing control and felt slightly insane. Now I'm just an anxious person in control, which should last a while from what I remember.
What you say about resensitization in a different way than before rings true.
Posted by SLS on September 23, 2012, at 22:14:49
In reply to Re: Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 23, 2012, at 18:52:17
> I've been back on 50 mg about a month, and the jerking awake problem has been going on a couple of weeks, though it doesn't happen every night.
>
> This never happened before, either fist time taking Luvox, or first time I dosed up to 50 mg.
>
> As for my psychological problems, they're there, but the Luvox gives me the mental advantage to fight off the anxiety better. The last time it took a long time (a year?) for me to feel normal going anywhere, and I suspect the same will apply now. But when I was on 37.5 mg I felt like at times I was on the verge of losing control and felt slightly insane. Now I'm just an anxious person in control, which should last a while from what I remember.
>
> What you say about resensitization in a different way than before rings true.
I think you'll be okay. It is good that you recognize the investment in time that it takes to recover. Hopefully, you won't have to wait another year to feel as well as you did before. Somehow, I doubt that it will take that long again.I wonder if guanfacine would help with anxiety. Its suppressive effects on norepinephrinergic function might offset any reduction in serotonergic function that you might be experiencing. I know it sounds whacky. It probably is.
For many people, Abilify works as an anxiolytic antidepressant. Unfortunately, some people react to it with akathisia-like startup side effects during the first week that include restlessness, increased anxiety, and insomnia. True akathisia is a possible side effect that would require discontinuation.
Good luck.
- Scott
Posted by jono_in_adelaide on September 23, 2012, at 23:42:07
In reply to Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 23, 2012, at 10:31:19
Given that Luvox works for you, and is working for you, I'd try riding it out to see if these effects pass off.
You could smooth out the process by asking your doctor for some diazepam (Valium)....5-10mg on the nights when these side effects occur would function as a muscle relaxant and also help you off to sleep.... if you have to discontinue Luvox, there are many good drugs out there, mirtazapine (Remeron) might be a good place to start
Posted by Prefect on September 24, 2012, at 19:03:14
In reply to Re: Reinstated Luvox dosage causing new side effects?! » Prefect, posted by SLS on September 23, 2012, at 22:14:49
Thanks for the advise guys. I can definitely ride it out, it's not the worst thing I've experienced.
I was just worried it might be a sign of serious agitation/suicidality/akathisia stories I've read on the internet, and I don't want to be a danger to people around me.
But I suspect I'd need to be a lot crazier to categorize it as that. Most times during the day I'm pretty calm, and the agitation is VERY subtle and occasional. And the nighttime shakeyness happens once a third night or so, especialy if I go to bed earlier than I feel tired enough to pass out.
Posted by phillipa on September 24, 2012, at 19:09:52
In reply to Re: Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 24, 2012, at 19:03:14
You can be my luvox buddy. Seems not many take it. Phillipa
Posted by phidippus on September 26, 2012, at 13:08:13
In reply to Reinstated Luvox dosage causing new side effects?!, posted by Prefect on September 23, 2012, at 10:31:19
>Now I have involuntary muscle jerks just as I'm about to fall asleep,
Its called myoclonus and is common with antipsychotics and to a lesser degree antidepressants. This should go away.
>odd feelings of tension mixed with slight mania/rage
This could be an LSA and you're experiencing the 'fight' of the fight or flight response. This wouldn't be a side effect, rather a symptom of your illness.
Eric
Posted by Prefect on September 26, 2012, at 21:12:10
In reply to Re: Reinstated Luvox dosage causing new side effects?! » Prefect, posted by phidippus on September 26, 2012, at 13:08:13
Thanks for the advise guys. No issues toughing it out on this front.
This is the end of the thread.
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