Posted by Ritch on September 25, 2002, at 23:43:06
In reply to fluoxetine, migraine aura, and delayed orgasm, posted by Etienne on September 25, 2002, at 22:05:14
> Hello everyone.
>
> This is my first time posting to the forum. I do so because I'm going out of my head.
>
> I have been taking fluoxetine (Prozac) more or less continuously for just over three years. I started on it after a depressive episode in early 1999 that was debilitating and frightening. I had been on it once previously (about three years before that, so six+ years ago) because of a smaller, less serious depressive episode. I stopped it after three months (at 20 mg/d) because I found it took my motivation away.
>
> Most of the last three years that I have been on the fluoxetine have been at 10 mg. Because of the severity of the depressive episode in 1999 I was taking L-tryptophan along with the fluoxetine for potentiation. Eventually I had to stop the L-tryptophan because I was feeling sleepy and dopey all the time. From that point forward I found the fluoxetine on its own to be very effective.
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> The only side effects (if you can call them that) that I've experienced have been somewhat dry eyes.
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> However, since I started the fluoxetine in 1999, I have made two concerted attempts to stop. I did this because my moods were stable, I was functioning well, and had successfully stopped before (after the three month course). My doctor advised that I terminate.
>
> Both times I failed. The first time I managed to stay off for 5 weeks, the second time nearly 8 weeks. The first time I restarted the fluoxetine because I found I was much more jumpy and anxious, and the insomnia which has plagued me most of my life returned. I found a change in light perception (everything seems less bright), enhanced clarity of thought but a reduced ability to focus on one task.
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> The second time I had to restart because of a gradually deteriorating mood and a traumatic life event. Again I noticed the reduced sensitivity to light and a difference in colour perception (everything seems paler).
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> Now that the background is out of the way, I'll get to the point, which is that in both cases, when I restarted the fluoxetine (sometimes with L-tryptophan, sometimes without) I actually experienced migraines. I have a light history of migraines, but they usually only come along every 4-7 *years*. In this particular case they were coming along 4 or 5 times a week, with a pronounced aura (shimmering lights, partial blindness, etc.).
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> I restarted in late May after the 8 week hiatus. I started at 20 mg, after about 4 weeks I had to go back to 10 mg because of the same negative effect on motivation (and also concentration). I was fine until early August. One morning after arriving at work I noticed that I had a slight tremor in my right hand. I traced this to a muscle weakness which became gradually worse until I recognized it as migraine aura. This is the first time I have had hemiparesis as a migraine symptom. I also had episodes of numbness in the face and very subtle visual aura.
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> It finally became so frustrating that I increased the dose back to 20 mg and avoided trigger foods. Things seem to be improving, but very, very slowly. Now I experience the hemiparesis on an oscillating basis throughout the day, and it is very mild. It seems to get subtly better each day.
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> Still, it's worrisome and frustrating, particularly considering that 10 mg was safe and effective for me for so long. Moreover, at 20 mg the sexual side-effects are noticeable (I didn't have much trouble at 10 mg). Especially so now that I have started a new relationship.
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> Has anyone else experienced migraine *induced* by fluoxetine? What did you do to resolve it? I'd prefer to avoid adding *more* drugs to the mix -- if there's a more natural remedy I'd like to try that first. I'd also like to find an alternative to the fluoxetine, as I miss the sexual vigour I had while off. I've tried L-tryptophan on its own without too much success, but I've heard good things about 5HT. Can anyone share their experiences with it?
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> Sorry for the long-winded post :) Your advice and personal experience is appreciated.
>
> EtienneHi, I am bipolar and was on fluoxetine longer than any antidepressant (seven years). I had lots of nightime hallucination episodes from it. Also, I had attacks of rather severe vertigo in the daytime (without vomiting), but bad enough that I couldn't drive until they subsided somewhat. My diarrhea-predominant IBS was aggravated by fluoxetine like no other med I have ever taken (with photophobia, and cold-sensitivity). You might consider reducing fluoxetine back to 5-10mg/day, and adding an effective antimigraine agent such as Depakote, Topamax, or Amitriptyline.
poster:Ritch
thread:121076
URL: http://www.dr-bob.org/babble/20020922/msgs/121087.html