having a bad time of things lately - did well on fluoxetine for about 3 months but started feeling like my short -term memory was really being affected badly (every bit as bad preganancy brain!) - so halved the ssri dose and now have constant dizziness, with sporadic short sharp vertigo and nystagmus, lots of imbalance, hearing dropped out of one ear for about 5 seconds the other day …AND continuing short-term memory loss - which I just can’t have in my job!!
amy really feeling very beaten by this thing at the moment…
It may have actually been the mav symptom not a med SE, its just the memory problems i have had for nearly the entire duration of my illness 4 years on sept 20th. It makes it tough when if the medication isn’t completely stopping the migraine then you can experience new symptoms from the migraine
And so knowing whats causin it can be difficult. I wish you all the best and i hope you find the right level again that suits you :).
What i would personally do is go back up to the original dose that helped with the other symptoms and then either go higher or add another med, but i would do this under my specialists advice on how to deal with that situation. I understand your feelings about this, it’s so difficult to cope but you will get there again, you will find that sweet spot :).
its 9 years for me now! - anyone got any thoughts on long-term SSRI use ??
I guess that’s one of my barriers - seems to be hard to get quality info on this because much of the internet stuff is dramatic and overblown and the more “official” stuff is based on drug company research…
What do people here think?
Your post sounds very similar to my recent experience. I’ve recently been reducing a trycicylic which I’d been on for a couple of years. Began to experience the constant dizziness, short sharp vertigo episodes and imbalance, fullness in right ear. I emailed my neurologist who suggested BPPV. Must admit was very sceptical but found a physio who could do the Epley manoeuvre. I’ve just had the third visit in three days and feeling much better. The physio did note nystagmus (a sure sign of BPPV apparently).
When MAV first hit and I did the round of ENTs, etc and had lots of tests for BPPV, Hallpikes, Epleys, etc. and it only made me feel worse and no nytagmus was ever noted even with the Frenzel glasses.
Will be emailing my Neurologist, Dr Granot, to keep him updated I’ll ask him why he thought BPPV might be the cause.
Over the past three years I’ve had several episodes of vertigo, falling, extreme dizziness, etc. He has usually either increased my meds or suggested a change so I’m interested to find out what prompted this diagnosis. Whatever, so far it seems to have done the trick for me.
Could be worth you getting the Epley done or even trying it yourself - Scott has a video link. Personally, I found the physio had a stronger approach to the manoeuvre. :roll:
thats quite interesting - when this first hit 9 years ago I was sent for vestibular rehab and had the physios do all the epley’s and halpike etc, the ENT confirmed nystagmus but the manoevers didn’t help and neither did the vesitbular rehab… however, looks like you’re saying that it didn’t work for you some time ago and now it’s helping… ?? interesting.
I also had the full audiology assessment (no hearing loss) but sadly they couldn’t get conclusive results on the ECOG because apparently my ear canals were too small too twisty! but came up with evidence of peripheral lesions… 2 MRI’s completely clear at a two year interval. SO… tomorrow its a new neurologist (in nine years I’ve been managing this with my GP and two ENT appointments where he just said “menieres variant” … good luck!) Gp has been great at trying new things (endep, topamax, serc, lexapro, OCP, - currently fluoxetine) but I think I now need to full work up with updated test results - $$$ swimming in front of my wobbly eyes…
I think if I don’t feel like this new guy “gets it” I’ll be off to Sydney to Dr Granot - anyone know if he’s still taking new patients?
sudden changes in SSRI doses can cause all kinds of rebound effects. Whether that was the original cause of your issues or not. I would recommend taking your prescribed dosage and calling your doctor.
Im not sure how where you would be travelling from, but Dr waterston from Melbourne at cabrini was great to do a through evaluation and diagnoses and has always been very easy to contact with any med issues and will reply the same day :).
Assume you didn’t just 'halve" the SSRI but titrated down otherwise the dizzies were sure to happen!! There are definite benefits to being treated by a MAV specialist - they have loads of experience in dealing with a wide variety of vestibular migraine symptoms and treating accordingly. You’ve obviously had loads of tests so there might not be a need to go through it all again!
However, the new neurologist might come up with something new - always hope! If not, both Dr Granot and Dr Waterston are highly recommended by forum members who have consulted with them.
actually I did just halve the fluoxetine! been two weeks now so I’m not going up again! but it has a very long half life so it’s one of the SSRIs that is thought to be less likely to cause dizziness from dose reduction and withdrawal…
Any way - new neuro thinks the memory loss is neurological and not related to the ssri - his new theory is along the FHM gene theory with a mutation in cancel channelopathy and he also said he has not seen anyone with symptoms as pervasive as mine… starting Diamox (acetazolamide) and titrating up from 125mg a day to 500 mg over the 6 weeks… fingers crossed. (staying on ssri half dose so as not to confuse the picture)
shall keep you all posted.
An update on the short term memory loss… I am fairly convinced this is not a medication issue now. I’ve been off the SSRI for three weeks (after a taper down over 4 weeks prior) and the memory loss still seems to come and go (Sadly, I now think this has more to do with the hormonal changes associated with being 46! as a precursor to menopause… it’s a lot like pregnancy brain…)
The diamox (acetozolamide) didn’t help much… so that’s gone too.
As I mentioned in another post - I’ve discovered the clearest link for “straight days” is when I’m taking an SSRI - so this is now the focus of my investigations and medication trials. Lexapro (escitalopram) had the best result for eliminating vertigo but I didn’t feel myself on it and it kept me feeling a little flat - Lovan (fluoxetine) had me feeling much better in myself but only 75% straight. Wish I could combine the best aspect of both of these…?!
All ideas welcome
what % were u on lexapro for the vertigo? did it help your balance/walking a lot? i wish i could tolerate an ssri ugh. i have been having some minor memory issues since this summer which i think could have possibly been from topamax or maybe a mav symptom OR just from being unbelievably depressed and anxious? who knows its not that bad but its disconcerting bc my memory used to be awesome
not sure if it was u i was chatting with on another thread about ssris but i took prozac for 10 years and it had no affect on my memory for what its worth.
Hi Sarah - yes that was me!
I also had an awesome memory! Now it’s only awesome on good days
— Begin quote from ____
what % were u on lexapro for the vertigo?
— End quote
I have had vertigo/menieres/bppv/vm??? for ten years now on and off with random bouts of “straightness”. Four years ago I was on lexapro as part of my recovery from a serious sceptic infection that had me hospitalised and very nearly in ICU. It left me so frail and unwell that I was riddled with anxiety and lex got me back on feet and able to cope and recover … looking back on my diaries I realised that post illness I had zero vertigo until I weaned off the lex 8 months later… it reappeared slowly after about 6 weeks and then stuck around. I am only just putting this all together now.
This is such an interesting thread to me and made me look back at my diaries over the last 2 years as well. I also saw Dr. Hain last week and we discussed how I need to keep my life in general on an even keel. The last couple of months my life has been hectic/stressful (holidays, new dog, lots of visitors) and my dizziness has been awful. Nearly as bad as it was at the beginning. I also was getting a little sloppy with my caffeine and alcohol intake. One big thing that was very apparent was that a crash occurs for me after I have cut down on my Zoloft.
My initial crash happened after I came off Zoloft 2 1/2 years ago. I was seeing a therapist who said it was numbing my emotions and that I should come off it. Well, what do you know, 2 months later (again after a busy holiday season and some other stressors) came the BIG crash. I went back on the zoloft at a very low dose and eventually ramped up to 100mg which seems to work quite well for me although dizziness was always there. Dr Hain suggested that I start tapering off in October as I was taking effexor (doubled dose at that time) and he thought it was unnecessary to take both as they were both mood suppressants. In my mind the effexor suddenly seemed to lose its efficacy at the doubled dose but in I wonder if it was me tapering down to 50mg zoloft.
I don’t think it is the zoloft which affects my memory issues (I have been on some sort of ssri for the past 12 years off and on), I know it is the vertigo that makes me start a sentence and forget what I was going to say or have trouble finding the right words.
Hope this email makes sense as I get confused when I am trying to explain something :lol:
this is very helpful and it highlights a number of things for me. Firstly that it can be really hard to differentiate between and neurological symptoms (originating from the vestibular/migraine “condition”) and a pharmacological side effect, and, especially for women, between some of the hormonal impacts on mood, brain, memory that vary with age. For me, recognising that medications really CAN take around 8 weeks to kick in and then can also take 8 weeks to “Kick out” after stopping was a key discovery in my diary.
It also reminds me that we do need to do our own research in conjunction with Drs advice and the wealth of anecdotal evidence that comes from each of us directly when we have quite unique responses to medication. That’s where this site really helps.
Three Drs have told me that they think the memory issues are more likely related to the vestibular condition than the meds and and I’m now starting to believe them! If I can be confident about this one thing - it will help me accept the possibility of long-term ssri therapy. Off the the neuro today and I’ll also try and get some details in my signature so my posts have some more context.