Zoloft - decrease in seizure threshold

[elizzza811]

My family doctor prescribed Zoloft for me several months ago due to depression, agitation/moodiness, severe anxiety, and already severe and worsening OCD. We started at 50mg (along with 0.5mg clonazepam twice daily) and VERY slowly increased the Zoloft to 125mg.

I felt great at 50mg and even better with each increase...the greatest I'd felt in a decade!...(though my R hand would shake and twist frequently in the mornings, sometimes wildly - I could live with that though!). But once he raised the dose to 75mg, I began wetting the bed. 100mg - still wetting the bed. 125 - diarrhea in bed, so I dropped back to 100mg. (Wetting the bed? I could live with that too! That's what they make Depends for, right?)

I just saw my neurologist and she believes these are seizures due to a lowering of my seizure threshold caused by the Zoloft. So she dropped my dose of Zoloft all the way down to 50mg (she halved my dose) and increased my bedtime dose of Lamictal to 200mg. (I had been taking 150mg twice a day for independent generalized epilepsy with simple & complex partial seizures/focal epilepsy.) My family doctor doubled my dose of clonazepam to 1mg twice a day hoping that would help my anxiety, mood, etc... since the neurologist left me wanting for that higher dose of Zoloft.

And guess what? I'm now wetting the bed even at 50mg of Zoloft, even with all these changes. So now I'm down to 25mg of Zoloft, taking 1mg clonazepam twice a day, and feeling miserable again. I believe the increase in Lamictal has caused severe constipation too, a double whammy.

I'm about ready to just surrender my driver's license, sleep peacefully, seizing and wetting the bed at night, just to feel cheerful and less anxious again.

There are no psychiatrists in my area taking new patients...sooo many psychiatric meds lower the seizure threshold - I'm thinking it would make more sense for a neurologist to treat my depression, etc... but they won't.

Thoughts?

 

[elizzza811]

I should also mention that I was lucky to get 4 hours of broken sleep on Lamictal, even before she bumped my bedtime dose up. Zoloft helped me sleep. All clonazepam does is reduce my anxiety and make me feel 'flat', depressed, gloomy, and irritable (on a mere 25mg Zoloft). I took 50mg of Zoloft last night just to get some sleep so that I could watch my dad who has dementia today. I had my husband drive me here, but my R hand already has the tremors. Don't my doctors care if I SLEEP?


.

 

[Cint]

I take 200 mgs. of Zoloft daily to help control my depression. It helps me tremendously with that issue. But I don't wet the bed. It could be seizures, as SSRIs could bring on seizures. I also take Keppra and Topamax for seizures. Sometimes the docs use AEDs like Lamictal and Clonazepan to treat mood disorders, too. And both can cause abdominal problems, either diarrhea or constipation. Call your drs. back and have them work together.

 

[EDBRAD]

I had been switched from prozac to zoloft a while back because of worsening hand & head tremors. The zoloft helped the tremors to some degree and had no side effects like you mentioned & I really didnt notice ant increase in seizures. I gradually was increased to 125mg but continued to have very high hills and extremely low valleys. I eventually went back to 40mg prozac daily. Although the tremors reared their ugly head again, the prozac has kept me on a much more even keel. Of the several anti-depressants I have tried, It does seem to be the only one to work for me personally. That is interesting to hear about zoloft causing your tremors.
Ed

 

[elizzza811]

Thanks for responding.

My neurologist does believe these are breakthrough seizures due to the initiation of Zoloft. The clonazepam was increased in hopes that it would help stop my presumed seizures, but it did nothing that way. Even this worries me because my family doctor told me this is what they give you in the ER if you're having a seizure. So why isn't it helping me?

My neurologist ordered a bunch of tests...MRIs of my brain, c-spine, thoracic spine, and a 72-hour EEG - the latter of which is to be done at the end of the month. I'm not sure I can handle only 25mg of Zoloft until then...I can't sleep...I don't even feel tired on the Lamictal and that small 25mg dose of Zoloft. And then I feel like a troll to everyone around me the next day.

I see a specialist on their 'epilepsy team' in early February...maybe they can change my seizure meds then. But honestly I'm beginning to wonder if Lamictal was helping to prevent my seizures by waking me just prior to one...like wide awake...or keeping me awake past the time I'd normally have one...between 2am to 4am-ish?

What side effects are you experiencing on the Keppra and Topamax? Agitation? Weight gain? Insomnia? I worry about these.

 

[elizzza811]

Ebrad, thanks for responding too. Unfortunately, Prozac never really helped my depression/anxiety. Paxil too I tried a year ago, Both made me jittery and gave me even worse insomnia.

Thing is with the Zoloft I'm currently taking only my R hand tremors (usually), sometimes so badly that I can't get a fork to my mouth at doses above 25mg. I have a L-sided seizure focus, but my neurologist, even one of their neurologists on their 'epilepsy team' blamed this on anxiety. They sure sound like simple partials to me.

 

[EDBRAD]

Hello Elizzza
I had the same issues with paxil-always feeling like I needed to jump out of my skin, as well as grinding my teeth & being pop-eyed. It was a mess for me.
My tremors have been strictly in my left hand-constant tremors & fluttering when I walked, also a bobble head. That is really swell when I go in for haircuts. It has started to migrate to my right hand recently but I guess I am just a shakey old dog. I tend to look kinda silly at times but it is definetely the lesser of two evils when up against depression.

Hope you find the right drug combo that fits for you.
Maybe we just need to find a good currendera to throw her chicken bones in the air & find that majic cure-all. Oh well
Good luck to you in resolving all your issues
Ed

 

[Howll]

I suffer severe anxiety, I managed it for years until my last seizure, that's when it all came flooding back (mines mainly health related). I got prescribed Zoloft after going to the doctors, not knowing its side effects. Two days into taking 50mg, I had a funny turn while out in town, strong Deja vu. I've only rarely had a petit mal, but it seems too weird that after taking the Zoloft I had one. Since I don't take AEDs, because my seizures are very few and far between, it just didn't seem worth carrying on taking the Zoloft.

SSRIs are great for many, but they aren't a cure. Anxiety is a bitch, but just try and remember it's harmless, it's not real and instead of fighting against it, just try and live by it. When you feel you're about to panic, let yourself go and panic, this will train your brain into realising that the panic won't do you any good. It's been 6 weeks now since my last full blown anxiety attack. I've been working with mindfulness techniques, cutting out caffeine and alcohol, taking time out for myself to reflect, keeping busy with little things like adult colouring, learning to knit, reading, playing video games. And not to mention, pushing myself out of my comfort zone. This from six weeks ago when I was freaking out and breaking down at the thought of travelling 15 minutes on a bus to work, which I've done every day for the past five years! There's a way out of it, and meds for you may not be that way.

 

[elizzza811]

EdBrad, just wondering, do you have focal epilepsy?

I have a spot on the left side of my brain that goes haywire, so most of my tremors affect my right hand. Sometimes they just shake...other times my wrist will twist and shake as if I'm unscrewing a light bulb. Funny thing is that at my checkups my neurologist always makes me pretend I'm unscrewing a light bulb with each hand as part of her assessment. lol I've had the finger-flitting/fluttering episodes too...when it's really bad it looks as if I'm typing. lol

She did say I also had something going on somewhere on the right side of my brain too, though apparently the left-sided one is worse.

The two of us would probably turn some heads standing next to each other in public. lol

Thanks for your words of encouragement,

 

[elizzza811]

Howll,

I only wish I could handle my anxiety that way. In fact, I've been ordering crocheting and knitting books but have been too anxious about other things...lol...little things that just set me off and hurl me into a meltdown. I'm lucky to have a patient and understanding husband because, off of meds, I'm a troll.

Also, some of my seizures involve an aura of 'agitation'. I have been told I stiffen up and clench my fists/teeth as I feel the electricity beginning to funnel through my spine, through the base of my skull. It was almost as if I had to 'brace' myself during that one because it felt as if my head was about to explode.

I've read that a left-sided seizure focus makes one more prone to psychiatric illness, and that's what I have...lucky me! Anxiety, OCD, and depression...they're sooo draining. Happy for you though that you're able to go the drug-free route. I only wish I was that strong.

 

[EDBRAD]

Elizzza
Yes I started out in the early '90s with complex partials, was completely controlled with meds for about 10 yrs. Then started having simple partials that have become more & more frequent, but all my scans have come up clean-no termites or rats nests up there for now. Tremors only started a couple of yrs ago. They are just constant resting tremors & when I walk my left hand starts fluttering. We would be kind of a mess seen together.
Good to hear you have an understanding husband. I too am lucky in that respect. In spite of my wife being handicapped, she is the one who steers me in the right direction. She is also the brains of this outfit so Id be lost without her. It makes all the difference in the world to have somebody that will go thru all this with you, doesnt it?
You have a great new year & we will probably see you around here in the hood.
Ed

 

[Cint]

I see a specialist on their 'epilepsy team' in early February...maybe they can change my seizure meds then. But honestly I'm beginning to wonder if Lamictal was helping to prevent my seizures by waking me just prior to one...like wide awake...or keeping me awake past the time I'd normally have one...between 2am to 4am-ish?

It's great you're finally getting to see an epilepsy specialist. Hopefully, he/she can find the right med combo that will work for you. And, if you're going to be seeing an "epilepsy team", there should be someone on this team who can treat you with the right med(s) for depression/anxiety, also.

What side effects are you experiencing on the Keppra and Topamax? Agitation? Weight gain? Insomnia? I worry about these.

When I initially started taking Topamax (Dopemax)years ago, my dr. had me go up to a higher dose than I am now and I started losing weight. Plus, I was really, out of it. Topamax can make one a space cadet. So we went off for a few years. Now I take a low dose. Keppra hasn't caused any different side effects than any of the other meds I've tried. And I've tried many. It does help control my seizures better than any med.

 

[Cint]

I suffer severe anxiety, I managed it for years until my last seizure, that's when it all came flooding back (mines mainly health related).
SSRIs are great for many, but they aren't a cure.

Anxiety, mood disorder, depression, whatever one wants to call it, all can go hand in hand with Epilepsy. They are ALL brain disorders, therefore need to be treated as such. A well trained neuropsychiatrist is the one who needs to do this. Unfortunately, few neurology clinics have a neuropsychiatrist on hand so don't know how to treat the anxiety/ depression that goes along with E.

Read these for more insight:

http://www.epilepsy.com/learn/impact/moods-and-behavior/mood-and-behavior-101

http://www.epilepsy.com/learn/impact/moods-and-behavior/mood-and-behavior-101/anxiety

http://www.epilepsy.com/learn/impac...ood-and-behavior-101/stress-mood-and-seizures

Anxiety is a bitch, but just try and remember it's harmless, it's not real and instead of fighting against it, just try and live by it. When you feel you're about to panic, let yourself go and panic, this will train your brain into realising that the panic won't do you any good. It's been 6 weeks now since my last full blown anxiety attack. I've been working with mindfulness techniques, cutting out caffeine and alcohol, taking time out for myself to reflect, keeping busy with little things like adult colouring, learning to knit, reading, playing video games. And not to mention, pushing myself out of my comfort zone. This from six weeks ago when I was freaking out and breaking down at the thought of travelling 15 minutes on a bus to work, which I've done every day for the past five years! There's a way out of it, and meds for you may not be that way

.

But remember, too, when a person is having seizures often, anxiety will probably remain with them. So will the meds.

 

[Nakamova]

elizzza -- you might ask your neuro about the possibility of splitting the Lamictal into three doses (morning/midday/bedtime). It helped Arnie (a CWE member) control his seizures when nothing else did. Something about the steadier dose schedule perhaps. He and his docs had tried all kinds of things (including a VNS implant) before the three-dose approach did the trick.

 

[elizzza811]

EdBrad, so glad that you have a supportive spouse too...I think that makes all the difference.

My question though...if your neurologist thinks these hand tremors are simply partials, does he/she allow you to drive since your EEG is 'clean'? My 72-hour EEG last year did show abnormalities, enough for them to bump my Lamictal up and to instruct me not to drive, but since the 3-day EEG didn't show an actual seizure, she gave me permission to drive again. This baffles me because a mere thumb twitch back when I was first diagnosed was enough for her to delay my getting my driver's license back.

 

[elizzza811]

Cint, thank you for the info on the meds. I really think Lamictal may be preventing my complex partial seizures (at least when I'm not taking Zoloft), but I never felt like it was doing 'enough'...I have this tugging sensation in my lower gums/teeth that won't let up which I believe is an 'electrical' problem because magnets do help.

I've sooo wanted to at least try some of these other meds I notice others are on...Keppra, Topamax...but my current neurologist seems to like Lamictal. Hopefully the specialist I see next month with try something different from Lamictal. It seems like Keppra is a stronger med? Am I understanding that right? Maybe this drug combined with a small dose of Topamax would allow me to remain on Zoloft? Maybe I wouldn't even need Zoloft. I do have problems sleeping so maybe Topomax at night would be a good thing for me? lol

Another reason I'd like to try Keppra especially is because my dad has Alzheimer's and there is a study out there that says Keppra might help. I fear getting this disease because it is painful to watch my father's brain shrink. Problem is they don't like to fund studies once generics are available. I painnn for my dad because of this.

http://www.peoplespharmacy.com/2015...everse-memory-problems-leading-to-alzheimers/

I just hope the epilepsy specialist I see next month focuses on my epilepsy and not my OCD. Last time I saw one of their epilepsy specialists the first half of the appointment was more like a psychiatric intake. I want them to 'forget' my OCD for once and focus on my seizures.

Thanks again!

 

[elizzza811]

Nakamova, maybe you're right? I do think my bedtime dose would still need to be the highest though because my seizures appear to be nocturnal (the bladder/bowel incontinence on Zoloft).

Funny...my sister, a nurse, thought it was overkill to do an MRI of my thoracic spine because I'm not incontinent during the day, only at night when I'm sleeping.

Thanks though for your input. The thought of a VNS implant scares me, so I'm hoping that's not something they suggest!

 

[Nakamova]

Funny...my sister, a nurse, thought it was overkill to do an MRI of my thoracic spine because I'm not incontinent during the day, only at night when I'm sleeping.

This makes sense, since an MRI would be looking for a structural cause, something that might cause incontinence at any time of day. Since your incontinence is only at night, that suggests that a neurological cause instead. But who knows, maybe there's more than one thing going on...