Posted by Sunnely on July 13, 2000, at 23:20:29
In reply to Prozac causing eye twitch?, posted by SueG on July 13, 2000, at 17:49:02
> I seem to have gained a very annoying twitch on my left lower eye-lid. It began a few weeks ago, just once or twice per day but now is happening every 5 minutes or so. Is this known to be a side effect of Prozac? It seems to have co-incided with my starting this medication. I am into my 5th week now. No other real problems with the medication besides the odd sleepless night and delayed orgasm - nothing I can't put up with at this stage. Otherwise it is doing great things for me. I am on 20mg/day.
> Anyone else had any eye twitches????
> Sue======================
If you noticed the occurrence of eye twitching with the start of Prozac and continues to worsen while on this drug, most likely it is the main culprit. (Unless you are taking other drugs that may cause similar problem.) Not to cause undue alarm, I have a gut feeling that you are experiencing the beginning of a condition called "tardive dyskinesia" (TD). Eye twitching or tic has been reported with the SSRIs. Sometimes, it is accompanied by other involuntary facial and mouth movements. Tardive dyskinesia is one form of extrapyramidal symptoms (EPS). The other forms include dystonia (muscle rigidity), akathisia (motor restlessness), and parkinsonism (e.g., tremor).
EPS is believed to be due to the blockade of brain dopamine action. SSRIs (Prozac, Zoloft, Paxil, Luvox, Celexa) are known for their serotonin-boosting effect. Serotonin is a brain chemical which exerts some influence on the action of dopamine i.e., it is a "neuromodulator" of dopamine. Increased serotonin action leads to decreased dopamine action.
Tardive dyskinesia (TD) has been known to occur with the antipsychotics (more common with the older drugs). However, there are increasing number of anecdotal reports published in the literature of TD from the use of SSRIs (more common with Prozac). The exact cause of TD is unknown but it is believed that after long-standing blockade of the dopamine receptors, they become "supersensitive and overactive" leading to the involuntary muscle movement known as TD. This is known as the "supersensitivity of postsynaptic dopamine receptors" hypothesis. Muscle areas more commonly affected by TD are the mouth and facial muscles. Patient may develop repetitive tongue protrusion or darting, chewing, puckering, sucking movements of the lips; facial twitchings, teeth-clenching, etc. The eye muscles may be affected such as twitching, frequent blinking, and spasm/tightness called "blepharospasm." ("Blepharospasm" can be sometimes so severe that a series of injections of a drug called "Botox" have to be given in some cases to alleviate the problem.) TD can be very distressing and sometimes irreversible if not recognized and treated early.
I suggest you discuss this matter with your physician. At times lowering the dose of the medication may alleviate the problem. However, in most cases, a change in the medication may be the best approach to alleviate this potentially serious problem. To continue with the offending drug risks worsening the TD which could eventually involve the other muscle areas.
An excellent description of eye twitching (and other dyskinetic movements) caused by Prozac can be found in the book "Prozac Backlash" page 29, "Maura: A Case of Disfiguring Tics."
poster:Sunnely
thread:40349
URL: http://www.dr-bob.org/babble/20000708/msgs/40378.html