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11/02/2009 05:26 AM

Losing hope. Twitches/jerking at night.

dvskittenPosts: 6
New Member

Hi everyone. I've been on the SSRI rollercoaster for years. I never ever had a problem sleeping, even when I was at the height of my anxiety (GAD and panic disorder). My dad passed away two years ago and I had a difficult time coping, so one of the meds I was put on Wellbutrin and Lamictal. I stupidly stopped the Lamictal abruptly b/c I didn't like how it made me feel, so I started the Wellbutrin. A few days later, I started having massive myoclonic jerks at night. All my doctors said I should have never been put on Wellbutrin b/c the seizure threshold was very high. The jerks eventually got better on a regimen of Klonopin. I don't want to be on such meds b/c eventually the body inevitably creates a tolerance for them, so you either have to up the dose or go thru withdrawals, which I believe I am experiencing now. I have been off the Klonopin for about three or four months and the Zoloft for about 10 weeks. About two weeks ago, I started with the jerking and twitching at night as I'm falling asleep. I know it's normal for the body to twitch as it is trying to get in a sleep state, but my jerks wake me up and it is almost impossible to get to sleep or feel fully rested in the morning. I'm wondering if anyone has had this experience with withdrawal off Zoloft or any SSRI and is there a light at the end of the tunnel. I already have an appointment scheduled with a neurologist and my pcp this week to rule out anything else that might be causing these jerks. I'm hoping these SSRIs didn't cause any permanent damage. Sad

11/02/2009 07:11 AM
ShoeGirlPosts: 166

Welcome to the group! I hope that you find comfort here. We have many great people, a great support group Smile

I really hope that you find some answers at your neurologist visit. I am on Celexa, an SSRI. I've stopped them before (cold turkey - the wrong way!) and gone through heavy withdrawal symptoms. It is crazy how your body becomes so tolerant. Although it seems our body just needs consistency, and it reacts to abrupt changes. Don't worry about the SSRIs causing permanent damage!

Keep us updated. I hope that you are having a peaceful day!

11/02/2009 07:35 AM
dvskittenPosts: 6
New Member

Thank you, ShoeGirl! I'm hoping that if this is still the withdrawal,that the doctors will at least put me at ease that it isn't something more serious.

11/02/2009 12:36 PM
Posts: 11022
VIP Member

Once you begin SSRIs your body actually stops making them, what little you already made. It takes a little while for brain to realize that it needs to start back up. I hope it's just a temp thing. I'm wondering if it could be restless leg syndrome? I'm sure the drs will let you know.

11/02/2009 12:39 PM
dvskittenPosts: 6
New Member

Hi, thanks for your response. I'm not sure, but all I know is that I never had any of these symptoms before I started the SSRIs, so I'm assuming it is caused by the absence of them now in my body. I'm hoping it's just my body getting adjusted to making it's own serotonin/Gaba, etc. I don't wish this on my worst enemy. It's not fun at all!

11/02/2009 12:50 PM
Posts: 11022
VIP Member

Here's some info on SSRI discontinuation syndrome

SSRI Discontinuation Syndrome

Part 1: A Risk of Stopping Taking Antidepressants

From PaulaHOST, for

Updated July 06, 2009

Symptoms of Arthritis

A scenario:

You've been on an SSRI antidepressant for five weeks or more. The doctor feels that the dosage needs to be decreased or the medication needs to be discontinued. He prescribes changes and tapering in the usual 10mg increments.

Within a couple of days of starting this, you begin to exhibit severe flulike symptoms - headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity. You wonder what the heck is going on.

It's called SSRI discontinuation syndrome, a result of reducing dosage or stopping taking these antidepressants, and it can really be the pits. Here is what causes it:

Some SSRI medications have a very short half-life. This means they produce no metabolites that help the medication stay in the body for an extended period. They go in, last a few hours, and come out again.

SSRI's are split into two categories: long acting and short acting. For example, Prozac is a longer-acting SSRI. Paxil, Effexor, Zoloft and Luvox are short-acting. The shorter acting SSRIs, when discontinued or when the dosage is lowered, produce an "anticholinergic rebound," which is an interruption in production of the key neurotransmitter acetylcholine. (Acetylcholine is the neurotransmitter used more when a person is under greater stress.) These symptoms will last anywhere from one to seven weeks, and then disappear.

Symptoms of SSRI Discontinuation Syndrome

Neurologic symptoms include:




•Difficulty walking

Somatic (bodily) complaints include:





Less common difficulties:

•Shock-like sensations

•Parasthesia (skin crawling, burning or prickling)

•Visual disturbances


•Muscle pain


Non-specific mental symptoms:

•Shock-like sensations


•Impaired concentration

•Vivid dreams

•Depersonalization - sense of unreality and loss of self


•Suicidal thoughts

Will I Get SSRI Discontinuation Syndrome? How Long Will It Last?

Double-blind controlled studies now indicate that 35-78% of patients who, after five weeks or more of treatment with the medication, abruptly stop certain antidepressants or titrate down in 10mg increments or more, will develop one or more of the discontinuation symptoms. When allowed to run its course, SSRI discontinuation syndrome duration is variable (one to several weeks) and ranges from mild-moderate intensity in most patients, to extremely distressing in a small number.

11/02/2009 12:55 PM
dvskittenPosts: 6
New Member

Wow, I have so many of those symptoms. I was on zoloft which is a short-acting med. Unbelievable. It states that the syndrome can last up to 7 weeks, and I've already been off it like 9 or 10 weeks. If anything, I feel that in the past couple of weeks, the insomnia (because of the twitching) is worse, not better. The irritability, dizziness, and vertigo are gone. The vertigo was really bad. Some days I felt like I was going to fall where I was standing. And to think that I titrated slowly and I am still having difficulty. Thanks for the info. I feel a little better and not so alone in this!

11/02/2009 12:59 PM
ShoeGirlPosts: 166

That is so interesting, thanks Amy!

A number of the symptoms on that list bothered me. Shock-like sensations, irritability, agitation, insomnia especially!

I will keep this in mind in the future when I decide I am able to come off the SSRIs

11/02/2009 02:38 PM
Posts: 11022
VIP Member

Hmmm...nine or ten weeks....that may not be related to the zoloft at all. Perhaps you need a full workup. Besides restless leg syndrome there's also something called sleep twitching. Here's some info on that.

Sleep Twitching

Sleep twitching happens when…

You are drifting into a peaceful sleep, while images start playing around in your mind.

Suddenly you feel like you have tripped down a step…and your whole body twitches like a fish out of water and wakes you up!

Sound familiar?

Yes…we have all experienced sleep twitching, sleep starts or hypnic jerks as they are medically referred to. And as far as jerks go, these ones are definitely annoying enough to get your attention.

Researchers are not entirely sure why sleep starts occurs…but there are several theories on the subject.

The first one states that these twitches are a normal progression from being awake to being asleep. As you fall to sleep your body's physiology changes to prepare for rest, i.e. your breathing rate, temperature and muscle tone changes. Perhaps the twitches are just a product of these muscle changes.

The second theory states that as you are falling asleep there is a point where your muscles are really relaxed and your brain responds to this change as an indication that you are falling and tells your muscles to move to inhibit a fall.

These sleep twitches are quite often accompanied by quick images of falling and are likely just quick hallucinations or similar to daydreams rather than dreams.

Sleep starts are common, affecting 80% of the population on occasion.

These sleep starts or muscle movements can also occur during REM sleep, the sleep when dreams occur as well. They are less common during sleep and are generally a sign of a more severe sleeping problem such as REM Behavior Disorder or Periodic Limb Movement Disorder.

1.REM Behavior Disorder (RBD)

During REM sleep we experience a muscle paralysis, to inhibit body movements that could endanger us while we sleep and dream. During this time all voluntary muscle activity stops. However, in people with RBD their muscles do not relax, remaining active, resulting in violent muscle spasms and jerking while asleep as they are acting out their dreams.

For more information on REM sleep click here.

2.Periodic Limb Movement Disorder (PLMD)

This is also characterised by twitching sometimes violently during sleep. Movements are quite often repeated every 30 seconds or so for an hour or sometimes even longer. And this pattern can sometimes repeat a number of times throughout the night.

I think I have the periodic limb movement disorder, but I've never done a sleep study so no dx.

11/02/2009 03:53 PM
dvskittenPosts: 6
New Member

Well, i've been reading up on the SSRI discontinuation syndrome and there have been cases where people have had the symptoms for months, some people as long as a year or more! OMG, I hope that isn't my case. I have to think positive or I'm going to drive myself crazy.

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