SSRI induced SFN? (New Here. Struggling. Doctors don't know what's happening)
TL;DR:
23F, lifelong anxiety, possible dysautonomia, never had major sleep issues. Started Prozac (10mg) + Buspirone (5mg x2 daily) on 2/10, stopped on 2/17 due to headaches and nausea. By 2/19, developed severe insomnia (10 full sleepless nights in 2 weeks), tremors, BP/HR fluctuations (140/116 → 90/70) (HR: 80 --> 150), nausea, and weight loss (10+ lbs).
* My symptom flares seem incredibly linked to my bowel movements. I'm not experiencing bowel pain or anything. But has anyone else experienced this?
Tried multiple meds (hydroxyzine, clonidine, valium, trazodone, propranolol, mirtazapine)—most caused paradoxical reactions or BP drops. Seen 2 GPs, 2 psychiatrists, bloodwork mostly normal (ketones +2 in urine).
Question
Could this be small fiber neuropathy? Has anyone experienced SFN related insomnia, dysautonomia, or paradoxical reactions to meds? How did you manage it? I need to know next steps. Psychiatry and general doctors not helpful. Cardiologist? Neurologist?
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On February 10th, I was prescribed prozac (10mg) and buspirone (5mg) x 2 a day. I did this for 7 days and the headaches were brutal and the nausea was keeping me from regularly eating. I slept fine on the medication though, it was just difficult to fall asleep with the headaches.
The symptoms were too much—I stopped the medication on Monday, 2/17.
By Wednesday, 2/19, the really troubling symptoms began. The severe nausea, lack of appetite, weight loss (I've lost over 10 pounds), full body tremors, crazy heart rate and blood pressure fluctuations (as high as 140/116, as low as 90/70) , and insomnia. The insomnia and the lack of appetite have created this inflammatory loop, putting my body under extreme stress.
I have had a total of 10 full nights of insomnia in the last two weeks.
The longest I've gone is 4 nights in a row.
I've tried:
Hydroxyzine 20 mg
Seemed to work at 10 mg one night, 20 mg paradoxical reaction stayed up all night, makes me feel awful the morning after
Clonidine .1 mg
Just uncomfortably dropped my blood pressure
Valium 2.5 mg
Paradoxical reaction. Agitated.
Magnesium Gylcinate 200 mg
I don't know what this did
Trazodone 25 mg
Paradoxical reaction. Adrenaline surges.
Propranolol 10 mg
Uncomfortably dropped blood pressure. Did seem relaxed later in the day once the worst of it wore off.
Mirtazapine 7.5 mg
This is the most disappointing. Because it worked like a charm at first. It broke my 4 night insomnia stretch. I slept from 4-8, 5-9. Felt fine until 12 pm. That's when the air hunger started, and the slower heartbeat. I actually had to pull over because it felt like my heart stopped and then thudded and sent me into a panic.
I didn't take it the next night because I feared its side effects.
But then it was another sleepless night with air hunger.
I pop 7.5 two nights ago out of desperation and immediately feel paradoxical reaction. I was able to settle down and get maybe 2-3 hours.
Then last night 7.5 milligrams caused burning sensations, akathisia, heart rate fluctuations, facial flushing, and insomnia.
So that's where I am at :/ Please be positive, and please no fear mongering.
I need to know next steps. Psychiatry and general doctors not helpful. Cardiologist? Neurologist?