A possible explanation for dizziness following SSRI discontinuation.

[squirrel]

Start » Publications
A possible explanation for dizziness following SSRI discontinuation.

Paul F Smith, Cynthia L Darlington

Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, Dunedin, New Zealand.

Journal Article: Acta oto-laryngologica (impact factor: 0.98). 02/2010; 130(9):981-3. DOI: 10.3109/00016481003602082
Abstract
Dizziness is the most commonly reported symptom of abrupt discontinuation from the selective serotonin reuptake inhibitor (SSRI) category of antidepressants. The reported dizziness is exacerbated by even slight head movement, and therefore is likely to be vestibular in origin. The SSRIs most implicated are those with short half-lives and which are most selective for serotonin (as opposed to noradrenaline), e.g. paroxetine and sertraline. Since the vestibular nucleus complex (VNC) has an abundance of serotonin receptors, the abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it. Here we suggest that the abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo.

Source: PubMed

[stan]

i have this dizziness, a slight head movement exacerbate it when i lie horizontal in bed;
many people have residual dizziness since years

[Sheila]

That's a good find, squirrel!

Their theory makes sense to me. It's interesting to learn that the vestibular system has a lot of serotonergic neurons. That serotonin sure does a lot of things!

There's also a nugget of very interesting information implied in the last sentence. It's not certain, but it looks like they're implying that if you get *bilateral* disruption of the vestibular system, then you get dizziness without vertigo.

So, then, if you get *unilateral* disruption (or, more likely, greater disruption on one side than the other), do you get vertigo?

You've done a lot of research and consulting about your vertigo, squirrel. Have you come across anything like this idea before?

[squirrel]

No i have not come across this theory before. I have not had dizziness ( as in spinning) mine is just a feeling of being unsteady, of the floor shifting underfoot, or like I am on a boat.

[Sheila]

That feeling of being on a boat for years is an incredibly stressful symptom, squirrel! You've really done a fantastic job of carrying on. I mean it.

[Mike]

Sounds like Disembarkment Syndrome. There is not much know about it but I wonder if you could find any online resources, forums, etc that might be helpful.

[squirrel]

hi Mike , Yes I have read about it but a strange coincidence that It started when I stopped Paroxetine.

[stan]

all my problems started when i tapered paxil or worsened after one year off; for me paxil worsened my weak areas

[Mike]

hi Mike , Yes I have read about it but a strange coincidence that It started when I stopped Paroxetine.

I was thinking same syndrome different cause.

[Sheila]

squirrel – There’s no question that your vertigo was caused by the Paxil, but Mike is bringing up the existence of a syndrome that has a community that might, possibly, maybe, perhaps have some insight that might be applicable to your vertigo.

I’d never heard of this, and I read the Wiki on Disembarkment Syndrome or Mal de debarquement –

http://en.wikipedia.org/wiki/Mal_de_debarquement

They don’t really know why some people – overwhelmingly middle-aged women – get this after being on a boat or other vehicle. I mean, most people don’t get it, right? It’s another mystery neurological disorder. Wouldn’t it be interesting if the people who get it happen to be on or coming off of psych meds, and no one has noticed that pattern?!

Meanwhile, the one tip the Wiki had for ameliorating it is this –

“For most balance and gait disorders, some form of displacement exercise is thought helpful (for example walking, jogging, or bicycling but not on a treadmill or stationary bicycle).”

I find this fascinating. It’s almost as if the nervous system is not satisfied with “fake” movement. It has to be real movement that moves you some place! This is how I feel about reduced fat milk – it’s not real! :)



squirrel -- did you happen to see the "Inspiring story of healing" thread in "Joe Sent Me"?