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Stress as a perpetuator

Hi Guys,

After a good, long old chat with TeeCee, and after reading Nub’s thread a while back on ‘Stress: A kill or cure?’ http://mvertigo.cloudapp.net/t/stress-kill-or-cure/5533 , I have really got to thinking about stress and it’s strong relationship with MAV/VM.

I think we all know that a lot of us seemed to have suffered either a steady build up of stress over a period of time or a suddenly stressful situation as a pre-cursor to the “BIG BANG” that kicked off our dizziness.

I know this isn’t the case for all of us so I’d like to run a poll to see how many of us suffered a stressful situation as a pre-cursor but I’m not sure how?

Nevertheless… I’ve often wondered why if our brains can suddenly switch dizziness and vestibular migraine activity on, one day, seemingly turning us from steady people to dizzy, spinny people with balance problems, why can’t our brain suddenly switch it off?

In trying to find an answer, I wondered if, (particularly for those of us who were suffering a prolonged period of stress in the run up to getting hit with this MAV crap, and more importantly, those of us who continue to find themselves ‘stressed out’ now), whether avoiding all stress in our daily lives now, and today, would allow our brains to reset and take us back to how they once used to be- i.e still, steady, balanced and dizzy-free.

It goes hand in hand, of course, that we are going to feel stressed BECAUSE we have this illness. However, if we can eradicate as much stress as possible, perhaps it’s possible to get back to good health?

Obviously I’m not scientist, but my thoughts here are that in the run up to developing MAV, adrenaline was pumped up, panic and anxiety were raised, for any of us who were stressed out or generally, had/have that kind of personality/character, we were constantly in the ‘fight or flight mode’. For me, I had dealt with a boyfriend having many scary seizures, ambulances, hospital stays. I was literally on the edge of my seat, worried sick.
Combined with my job, which is at a very much lower level, but similarly, fight or flight, what I would describe as, sitting on the edge of my seat, waiting to fire fight the incoming problems whilst also juggling many things- probably much the same as many other people here- in fact, how does anyone stay sane as a parent!!! … It stands to reason that the adrenal glands were working on over time and it wasn’t healthy.

Whilst thinking about this Friday night, as well as Saturday on the Eurostar over to Paris, I experienced my first 85% dizzy free day in a long time.
Guess what it coincided with? Being away from home. I was in Paris. I knew I had 2 days of doing whatever I wanted to. No demands on my time. Nothing to worry about. I felt slightly dizzy after spending 8 hours walking around the city, 3 hours of which were under flouro lights in department stores- but I knew that would happen. The next time I felt significantly dizzy was Monday, when I got lost in the office building, trapped between doors and had to call someone to come and rescue me! My heart rate physically went up, I started to panic, and BAM, back to the ‘usual’ level of dizziness I have at home 24/7.

I figure that I’m fine on holiday because I am not stressing. Even when I don’t think I’m stressing, I must be. How on earth do I over ride my subconscious??? Can anyone tell me? It seems that the only way I can do it at the moment, is to literally travel to a different country. And that’s not feasible or practical.

I guess we can start with the practical easy proactive things- mediation classes, taking time out to have a bath, read a book. My counsellor recommended ‘mindfulness’. It sounded a little like a bunch of mumbo jumbo at first, but actually finding 10 mins (how ironic) to sit down, listen and absorb, and think about it in relation to this latest lightbulb moment for me, actually makes sense. 10 minutes of no internet, no phone, no book, no nothing. Just stillness. She told me the NHS actually have a course on how to be mindful. Check this out:

Andy Puddicombe: All it takes is 10 mindful minutes

The little things may start at least to chip away… and are a place to make a start. But I can’t help but think somethign more drastic has to take place here.

Instinctivley, getting wound up as a reaction, tense and agitated is what I do. It’s a natural reaction for me. So how do you stop yourself from that split second “No, that is not a productive response… Instead, I want to respond like this…” It’s so hard.

Even on Saturday in the queue for the Eurostar a woman behind me moved to another queue at the same time as me. She then said loudly to her partner behind us, “We’d get there quicker if some people didn’t push in”… It took every single ounce of willpower for me not to turn round and make a sarcastic remark to her. This is exactly what I would have done under any other circumstance, but I had the conversation with Tony in my head and instead I acknowledged what I wanted to do but didn’t do it. It wasn’t a massive achievement, but it was a little one. Though it does illustrate how much of a struggle it will be to actually change a personality that is ingrained.

As well as perhaps personality and traits being changed, I really think job changes may also need to be looked at. As much as we don’t want to acknowledge this.
Is it perhaps better to change jobs or indeed take a break if possible, to rest, recouperate and get better? Don’t see it as a failure, or a step backwards- see it as a step towards getting better.
I think that’s really important.
I know I for one, would rather feel better than feel like this. Maybe I need to put myself into a different environment in order to feel healthier?
Perhaps it’s similar for others. It’s just so hard to know what to do for the best. And it’s a bitter pill to swallow.

I’d really be interested to hear other people’s opinions on stress, particularly stress as a perpetuator to this illness- I truely don’t believe I will get better until I somehow- GOD KNOWS HOW- manage to eradicate stress and become a calmer person- that is key. I think that will then unlock the cure. More so than a diet, or any pills.

I have to also say I do understand what you say Nubs, about not feeling the dizzies when dealing with loads of stuff- being busy. When my best friend died 4 months into me getting hit with this stuff- I had a few basically dizzy free weeks. I didn’t really question why at the time- I wasn’t think about dizziness. And I suppose that was the answer- I was thinking about things- I was in another world.

I do think that when you’re busy or under more pressure, the brain can often snap into coping mode and actually carry you through- to some extent and you end up realising you can cope with more than you thought. That combined with the fact that as someone else said, when you’re busy with other things, you tend to focus less on being dizzy- that really happens with me when I go shopping (in shops with ok lighting!). It’s one of the reasons I got obsessed with charity shops and car boot sales- I am too focused on sniffing out the bargains that I don’t often feel dizzy unless it’s unbearably horrendous or… until I stop shopping. It leads other people to think I might be making it up… ‘Oh, she’s ok shopping’… But I don’t let these people bother me.

No one knows what it’s like to be a dizzy unless they’ve been a dizzy.

Well, this has ended up being a bloody long post. If you’ve got to the end, thanks and sorry. It just started pouring out.

Looking forward to hearing everyone’s views on stress.

On that note, I’m off for a lavender infused bath and to chant ommmmmmmmmmmmm.

Love to all xx

1 Like

Hi Missmoss,

I’m really glad you had a great meet up after all. I know Tony thinks I will not get better while I am working so hard and generally putting myself under a load of stress and I expect he is probably right. He has been lifeline to me and a great friend so I am trying to listen.

I really do think my brain got used to being under constant flight or fight conditions in the year that I got ill and was not able to adapt to any relative relaxation afterwards. Whether that hindered my compensation from labs/VN or whether MAV hit me in a weakened spot or whether my anxiety went up a whole new level to chronic subjective dizziness, I have no idea. Nor does it really matter. I was having the worst year of my life and then this came along to ice the cake. And now I am still doing far too much, enough to make many a well person ill, whilst being ill. So not much surprise that I don’t recover. But as I said my brain seems to like it when I get back in the adrenalin zone and kick me when I try to keep out of it, so in the short term it’s easier to just keep on going, especially as that is what everyone expects of me. How does one go cold turkey and go for all out long term relaxation? Especially as I am seen to cope, probably better than most well people?

Has anyone on here just dropped out of the rat race and found complete rest to be the cure? Can the switch ever be tripped the other way?

I am also ten times better on holiday, even when doing quite demanding things like shopping and sightseeing as you say. It makes me wonder if stress isn’t not only my main( and only identified) trigger, but also such a big factor to say that this is partly a psychological disorder, albeit one which stems from an underlying physical weakness?

I’m really interested in people’s thoughts on this too so thanks for raising it again.

Nicola

My MAV developed amongst a period of stress.
Right now i am on maternity leave from work so shouldn’t be unduly stressed (just sleep deprived!) and my dizziness is no better, in fact sometimes i think it’s worse.
However on the rare occason i get to go out of have family/friends round i do notice i dont feel so bad? I think it’s more a case of when we dwell on our symptoms we up the anxiety and anxiety is a trigger to this, when we are busy we cant dwell.
Wish i could not think about this as much as i do :frowning:

Hey missmoss,
Great post! I think you are well on the way to helping yourself to heal or at least to cope better with this condition.I too have had the same thoughts and a-ha kind of revelation.Mine all started with extreme stress,I have always coped but this time it was like a blew a bunch of fuses and the downward spiral began.

Things have improved greatly for me stress wise but in the leaving of stress I have learned to evaluate my reactions much as you are doing in the example of the person changing lines.Just trying not to react,I could do it before and I realized that I could be that relatively calm person that I had been before all this crap started.

I take a buss to work every day.I sometimes do 2 round trips in one day.I started checking my body for tension,not in an obsesive way but just observational,little things like noticing that even though I was sitting down I was gripping my toes on one foot.
Realizing that I have a tendency as a lot of people do to not breathe fully,caught myself and still do holding my breath.

Taking a few moments to massage my sternoclasmodial muscles in the front of the neck.
Really trying to get a WTF attitude going.I know that If get vertigo I can most likely cope with it,I have done it hundreds of times it seems.I decided to try my best not to be in that hyper aroused state that is easy to get into when you watch yourself for symptoms and live in fear of what if…
That feeling alone for me was very freeing.

I too had been having thoughts about what the adrenalin rushes were doing to my body,not to mention Cortisol and all the other things that start to cascade when you have anxiety.I figured if I could try to check my reaction to stress,I would try to go limp,at least in my thoughts and try to just breath or think of something else or just sing to myself.I have found lately that if I start to feel anxious,singing out loud is calming for me.I think I read somewhere that this is good.If nothing else it distracts the brain.

I want to add that most of my stress was job related as a primary trigger,I am still at the same job but am working less hours there but am also free lancing at another place which has a better atmosphere.

I have gotten really long winded as well but I do so appreciate you starting this thread,I think a lot of people probably need to hear it.

I dropped out of the rat race due to MAV. The year I spent working with it was a living hell. I was under stress at work prior to MAV as I had just qualified as a solicitor and I was trying to be too eficient, respond to all emails and correspondence too quickly, not delegating enough to other people and just generally felt like my fight or flight response was switched on all the time even when not working I could not switch off and relax. I found myself getting more and more stressed internally over little things and then when MAV hit my anxiety/panic was through the roof due to the dizziness. I tried hard to push on through it but was living on the point of collapse and my fatigue became crippling.

Taking work and all stress out of my life allowed me to relax and focus on healing. It took about a year after leaving work for my stress to dissipate and for little things like someone knocking at the door or the phone ringing not to set my heart racinig. I would say that this slow paced lifestyle has helped the fatigue a lot. I was slowly improving until my relapse last summer which seemed to come out of nowhere. So my experience has been that the lifestyle changes help all the associated MAV symptoms like fatigue, stress, anxiety, aching BUT it isn’t a cure for MAV - the dizziness hasn’t just gone away and it has not prevented attacks/relapses. I was not on meds then so I am really hoping that meds may prevent any more big relapses of the dizziness but only time will tell on that one.

That’s just my experience, everyone is different. I believe that lifestyle changes can improve things and make the symptoms less severe and bearable however I don’t think it is the only factor in conquering MAV. xx

Hi MM

We should do a poll to work out if you was under a lot of stress before the big bang
Have you thought about CBT. I know Dr S and Linda Luxon both have a CBT specialist in there clinic. I friend of mine got great benefit out of it. It’s not everyone cup of tea. The NHS and NICE recommended it for anxiety and Depression etc.

Just wanted to add that what started my recovery was Verapamil and Amitriptiline.Resetting my brain.

that’s great you are feeling better james!!! How long have you been on both meds? What % do you feel on them? Did you have any trouble walking/balance and which helped with that?

Do you feel like stress can trigger your symptoms now that you are on meds?

— Begin quote from "sarahd"

that’s great you are feeling better james!!! How long have you been on both meds? What % do you feel on them? Did you have any trouble walking/balance and which helped with that?

Do you feel like stress can trigger your symptoms now that you are on meds?

— End quote

Hey sarahd ,
I have been on the verapamil for around 2 years?? It wasn’t the success story that I wanted as I still had problems.I have been on the Ami for about a year.Tried to go off last Fall but symptoms came back.

Last Sunday I had a bit of off balance going on.Worked through it,but It did come a bit out of the blue.I slept funny and don’t think that helped plus I am very sensitive to weather changes and have had a lot of those.

The jury has not really reached a definite diagnosis with me.My ent says Atypical Menieres,but now she is not so sure.My neuro says it’s mav.I do have hearing loss which is not typical with mav,however there are a few studies out there that say it can damage the ears.
I think they are part and parcel of the same thing.

What are you trying?

Hi Lou, Nubs, and all…
this is a great thread. I’ve always wondered why, if “NormalBrain + Stress = MAV”, then why doesn’t “MAV - Stress = NormalBrain”???!!
I can only think that with the brain being ‘malleable’, the stress and MAV have caused changes that can’t easily be undone: imagine a nice flat, pristine sheet of paper (the brain). The stress and MAV create folds - it’s as though someone has now come along and scrunched the paper up into a ball, or something. For sure, you can unfold the sheet of paper and make it flat again, but it’s not going to be the same - it now has all kinds of folds that can’t easily be flattened out…?

We strive to flatten the sheet of paper out, and meds for sure can do a great job - it’s like they’re ironing the paper flat again. But as long as we’re under stress, it’s like something comes along and starts folding/scrunching the paper again!? I’m not sure I’m making much sense here, so I’ll quit while I’m behind! :wink:

A couple of years ago, when I was in a really dark place and desperately looking for answers, I remember reading a story about a woman who was suffering with constant dizziness, and how she got better by saying to her husband and kids, “sorry, but I’m going away for a while…” and was looked after by her sister who lived in a peaceful, remote part of the country: for many months she did nothing but get looked after - her sister brought her food and drink and she said she slept almost constantly. I’ve tried to find it, but unfortunately cannot. I’m not sure what her dizziness stemmed from (MAV, etc) but it was interesting to me, nonetheless.

If we can get this MAV monster under control and ‘flatten our sheet of paper’, I wonder whether we may have to fundamentally change going forwards, in order to avoid creasing the paper again - perhaps by a complete change of attitude and adopting a calmer persona…?
Tony.

1 Like

Great post MissMoss! Like Jem, I’ve been out of the Rat Race for awhile now - not really by choice, but because sitting in front of the computer and travelling by train was making me puke many times every day and making me way too ill to continue. Running to the bathroom every thirty minutes is not conducive to productivity.

I’ve been off work now for nearly 11 months (WOW!!) and it’s taken nearly eight of those months for me to have some dizzy free periods - not full days, just a few hours. And getting to this stage is mostly due to Topamax and dietary and lifestyle changes. So I’d definitely say getting away from work is not a general fix. Yes, it brought my stress level down a bit, but not completely as I still have work related stress as I still have a hard time convincing them I really AM actually ill.

Before the ‘big bang’ I was working part time in a job where I wasn’t appreciated (once I returned from mat leave I was pretty much treated like there was no chance for promotion no matter how hard I worked because I was only part time), felt like a single mom during the week as my husband works long hours (though he’s a great dad on the weekends), and trying to sleep train a very stubborn toddler at the time. It was hard and I’m sure helped trigger the big bang. Being a massive control freak and perfectionist probably didn’t help! Not terribly stressful by most people’s standards, but I personally felt terribly stressed at the time and having migraines 1-2 times a week definitely didn’t help.

Since then I’ve learned to let go a bit. Things don’t have to be perfect. If I can’t return to work, so be it. Being a stay at home mom is sounding pretty good right now as it’s not looking too good for me to have a job on a computer as I still can’t handle being on one for more than 30 minutes and there aren’t too many jobs out there that aren’t computer based that fit into school hours as my daughter starts school in September. Being with her is more important than money. Funny how being ill puts things in perspective!!

Now that I feel a bit better, I fill every day doing something rather than sitting around doing nothing. Four months ago, before the Topa kicked in, I could barely get out of bed most days, so of course I felt worse then. Easier to dwell on the illness. While I still can’t drive terribly far or stay in stores for long (stupid lighting), I feel better on days that I fill with something, even housework or sorting out things. Nothing terribly stressful.

I did have a major setback last week when I went to Cheltenham - ugh. We go every year, my husband and daughter love it. I go to be supportive, and even took valium, but I really hate crowds. Record number of people this year, lucky me. The travel, the crowds, major triggers - set me off for a couple of days. Should have known better!

Haven’t forgotten about this stress thread. I’ve just been busy being STRESSED. :slight_smile:

Will reply as soon as. Thanks guys, it’s really appreciated x

Hi TeeCee,

I really can see that word picture you gave, I can so identify with that its great, as I am a visual, artistic sort of girl.

You know I think yo are right the idea of just stopping the world and entering a complete new calmer mode would defiantly help reset life style. Its when you go back to the other norm that would shunt you back again, I guess?

Hi Kay,
yes, I tend to see things as images/pictures, too. :smile:

At various points over the last 7 years, I have had recoveries, only to slip back. Dr. Surenthiran says that many people make the mistake of overdoing it too soon, so perhaps next time I’ll take it more easy!

Hi TeeCee,

It’s great to hear from you - an old timer :). Even though we didn’t “meet”, I read a lot of your posts.
I’m really hoping you are doing much much better. Sorry to hear you are still having some relapses. Since you’ve been through it for so long, can you share your experience of how this works?
Do you think medication is key? Life style? What exactly is not “overdoing it”? I know you said that Dr. S says doing too much too soon is a mistake but if you’ve got some decent control ( which I don’t), how do you know how much is too much?
Also, when you say you’ve had multiple relapses, were they all as bad as when you first got this? Were they quicker to get out of?
One more question: which meds have you found helped you? I know pizotufen helped you more than once. Did it continue to help? Any success with anything else? I want to try piz. soon and if that doesn’t work, something else.

I know this is a TON of questions. But I want to learn as much as possible about this and you must have so much experience with this that i feel like this is my chance to get some understanding of this. I’ve just had my 1st year anniversary with this two weeks ago.

I hope you can bear with me :).

Thanks a million already!

Asli

Hi Asli,
lol - “old timer”…yes, I guess you’re right - I do feel like an old-timer, having just had my 7th year anniversary! I will always help out wherever I can, since I know just how sh*t this all is, so feel free to ask anything you like (although I may unfortunately, not have the answers!).

Initially, I held off from medication, since I’m a worrier, and hate taking meds/drugs. I went onto a migraine diet, under the care of a Dr. Savundra, at the Great Portland hospital in London. The diet didn’t seem to make much difference (although I follow it most times, even today: no red wine, cheese, caffeine, cream, preserved meat, msg, bananas, etc, etc - the list is long!).

Eventually, I couldn’t take it anymore, and decided to try the meds. And I have to say, the meds are probably key. I tried to reduce stress, which is really important, but the meds were when I started to feel differences. If I look back to those early days (the first years or so), I’m generally much better now, overall. I don’t have such severe dizziness or imbalance, and I don’t get the ‘wobbly, marshmallow floor’ feeling.

I found a job that is much more local, so my commute stress is effectively zero. Also, the job itself is less stressful, luckily (I’m a software developer, so less stress is great). It was cummulative stress over a long period of time (years) that eventually lead to my big-bang event that let the MAV out of the box, so I guess it stands to reason that stress should be controlled wherever possible. I have always (God knows how) kept reasonably fit, by going to the gym, although it has been difficult sometimes, and I’m quite proud of the fact that I refused to give in. But I had one therapist tell me that it’s about avoiding sensitising the migraine brain - and I know that pushing too hard in terms of exercise, does aggrivate it.

I first had amazing success with Pizotifen, in the early days, but had an atrial fibrilation episode whcih lead to me coming off it for a while - to be clear though, that was NOT the Pizotifen - I have always had a heart that can ‘blip around’ at times. When I returned to the Piz, it had lost some of its effectiveness, but I returned to it again years later, and it worked again! This has been my story, generally - meds have helped, and then for some reason or another, lost their effectiveness. By the way, Pizotifen was one of the easiest meds, in terms of side effects, for me. I had EXTREME tiredness for a few weeks, but that passed.

I tried Topamax for quite some time, but to no avail. Perhaps I didn’t go high enough - I did reach 100mg, but it was one helluva struggle. I did have a friend on mvertigo who got a fix at 200mg, so who knows?

After that I tried Gabapentin, and like the Piz, I found it relatively easy in terms of side effects. I had an almost complete fix at 1800mg per day, and that’s when I remember feeling so good. It felt like systems in my brain became alive again, and I just naturally started thinking and creating, and becoming more active again. And then I relapsed, and it was at this time that Dr. Surenthiran told me it was common for people to overdo it.

So, we added Piz into the mix, and I found great relief once again. And I’ve been on the Gabapentin and Piz until quite recently. Once again, thMAV seemed to edge back in. So, Dr. Surenthiran took me off the Piz, and I’m now trialling Effexor (alongside the Gabapentin) It’s early days, but I had some side effects with the Effexor, despite cutting the 37.5mg tablet in half, and then quarters! Generally, side effects seem to disipate after a few weeks, if you can hang in there. I’m now taking a whole tablet (as of yesterday!), and feel OK. Go ‘low and slow’, as they say. There have been early signs of encouragement - a clearer, clamer head, so we’ll see.

My relapses haven’t taken me back to square one - they’ve generally been easier to cope with than in the early days. I think I’ve reached the ‘acceptance’ stage - this is here, and I have to just deal with it - co-exist alongside it, rather than trying to fight it.

Sorry to hear you’ve had the one year anniversary. I wish you all the best. Try to find the best consultant you can, reduce stress as much as possible, try the diet, and then look to meds if that doesn’t produce results. I guess it’s a multi-faceted approach.

Keep me updated!
All the best,
Tony.

Hi Tony, thanks a million and more. I do hope the day will come when you will no longer have to deal with it and forget all about it :slight_smile: .

I’ve trialled Propranolol (failed), am on 60 mg Nortriptyline. Though the Nort was definitely helping, once I added Zoloft, I got back to pretty much square one. I got off the Z trial (which lasted 2 weeks and killed me in terms of dizziness and headaches) three weeks ago but am still way worse than before the trial. I upped the Nort from 50 to 60 a week ago to see if it would help me recover from the Z fallout, but no joy so far. I’m in the US but managed to get some Pizotifen from Europe and am thinking of trying that next.

I’ve a neuro and a GP, both nice folks but don’t know much about MAV. I’ve resisted seeing a migraine specialist since I am wishing away this thing, hoping the next drug will help me - so sick of dr.s and don’t want to meet a new one! But you say work with the best consultant possible, so you make me think twice about that.

I’m glad you have a positive attitude and pretty much lead a normal life.

I’ll bug you again if I need to, so thanks for keeping the door open.

I wish you the very best and a miraculous total cure :).

God bless.
Asli

Hi Asli,
Thanks so much for the kind wishes.
One thing I would emphasise is the importance to many people with MAV of going ‘low and slow’ with drug trials. It often takes a few weeks for side effects to disappear and benefits to show themselves. So, with the Zoloft, could you have gone ‘lower and slower’ (e.g. split tablets in half or even quarters) and only incremented the dose when side effects have settled a little?

Thanks again - all the very best for finding your cure! :slight_smile:

Hi Tony -

thank you for your thoughtful note.

Yes, I understand what you mean with “low and slow”. It took me from the end of January to end of August of this year to just go up to 50 mg. on Nortriptyline - not because I was feeling well in between and had to bump up due to relapses but because I went up by 5 mg. every four weeks just to avoid issues. That’s ridiculously slow but I was afraid of the consequences.

Regading the Zoloft, I think I could and should have gotten much much slower - start max at 10 mg by cutting the tablets, even though the minimum dosage is 25 mg. tablets. But the GP said she normally starts people at 50 mg. straight but b/c I am so med sensitive, she’ll start me at 25 mg. I think neither her nor I understood how excessive that “small” amount for me was. I do think too, that Zoloft must simply not have been the med for me. It shredded me to pieces while on it and after getting off, I had substantial withdrawal sx for 3 weeks!!! Longer than how long I was on it to begin with :frowning: :frowning: . It’s ridiculous. But it’s a lesson learned: no matter how small the dr.s might think a starting dose is I should always go with a fraction of it.

Tony, do the fluorescent light (in shops, at work etc.) bother you? How about being hungry? Those two are my worst triggers.

How is your Effexor trial coming? I hope you are getting along well with it :slight_smile: .

Kind regards and thanks.
Asli

Hi Asli,
I can see you definitely know the meaning of low-and-slow! :smile:

Flourescent lights don’t seem to bother me, but I wonder if they exacerbate the problem without me even realising, if that makes sense. Being hungry never used to bother me, but lately I seem to feel it more.

Effexor has been a little bit rough for me - some reasonably severe headaches (which I don’t usually suffer from), stomach a little upset, and an edgy anxiety - all this, even on just 1/4 of one 37.5mg tablet! I did have an atrial fibrilation episode lasting 5-6 hours the other night, but since the dosage is still relatively low (I’m now on one 37.5mg tablet), and my heart already had a tendency to do that (although only once every 2 years or so), we concluded that it might just be coincidence. However, it definitely has made my heart beat faster on occasion (I awoke the other night with it around 120bpm, whereas it’s usually only 50 or so).

Don’t you just love med trials…sigh?! :wink:
Best wishes,
Tony.