Dizziness and stress

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Hi, I've been dizzy for several weeks since I stopped taking bendruflumethiazide 2.5 mg and citalopram 5mg. My doctor switched me to amitriptyline, then propranolol and ramipril, then to losartan and the bendroflumethiazde again, all in the space of three months. My pulse rate escalated my bp was all over the place, ended up in A&E. Bloods, ECG and BP normal. I am not on anything at the moment but the dizziness persists, I'm feeling down and I cry a lot. I am going to ENT on doctors referral. There is a lot of stress at home, my husband is ill and he has insomnia. My nights and more worry and stress. I really want to know if anyone can relate or offer words of hope. Thank you.

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  • Edited

    hi im so sorry to hear your feeling like this a ive recently been perscribed propanolol to stop my anxiety attacks when mine started a couple of weeks ago i havent felt the same since as long as you have been checked out thats the main thing , i would say that it is exhaustion because of your anxiety it can make you feel tired and dizzy one recent symptom ive had is that my eyes have started to hurt as well as headaches i would reccomend councilling and meditation on an app called calm , sleeping habits and your body being unable to relax play a major part in this. feel better soon

    • Posted

      Hi Kenz, thank you for replying. I hope you get on ok with propranolol, unfortunately they gave me horrible side effects, tiredness, lethargy and light headedness but I know they work great for others. Also with me I did quite a bit of swopping and changing meds which didn't help. Your right about exhaustion, that's how I feel, sleepless nights, a sick husband all takes its toll. Maybe your headaches and sore eyes are down to getting used to a new med. They can take a while to get used to even though they supposed to be fast acting for anxiety. Thanks for the app tip, I'll take a look. Here if you want to chat. Take care.

    • Edited

      Hi no your completely right about the tiredness as well i have the same on these tablets which is why i have started to drop my dosage on them to just at night before i go to bed, one thing i can really reccomend is ashwaganda ive been taking 5000mg once a day you can buy it on amazon , hope this helps you , wish you the best it will get better

    • Posted

      Hi Kenz, thanks for the tip. I'm seeing my doctor next week to discuss meds, I'll mention this to him. How are you today, any better?

    • Edited

      Hi im a lot better how about you , also i have had propanol for my meds to help with my anxiety ive just seen your other response to your ecg please do not worry about your heart rate , ive had bloods and ecg done when my anxiety was high i started getting really anxious whilst having it done thats all that will be and if anything being anxious and having your heart tested can be a good thing because alls that has come back is that your heart rate is fast whilst your anxious thats completely normal ! propanol has been really good for me and im just about coming off it helps keep your body calm whilst your mind is anxious so i do recommend if your doctor can put you on that , i also have a blood pressure machine at home and my blood pressure is and heart rate is normal when im not anxious. please try not to worry you will get through this !

    • Edited

      sorry just realised you already said about propanol not being the best for you , some other things i can reccomend to do is bath before bed , lavender spray , calm app is really good for meditation and breathing techniques , incense as well if you can get a hold of that.

  • Edited

    Hello Jan

    I can absolutely relate to what you describe, I have suffered with dizziness and continue to have issues with feeling woozy and off balance. It worries me a lot but I think that makes it worse. I spoke to a nurse at my surgery and she said that hyperventilation can cause dizziness and for me, I tend to hold my breath when I'm stressed (which is much of the time). You are dealing with a lot, caring for someone who is unwell is incredibly hard and if you're not feeling good yourself, it can feel almost impossible. I do understand because I've been in the same situation but mine was my Mum. I'm like you, I'm very down and I cry alot too. I hope you feel better soon, but remember you are not alone and there are people here that will always listen even if we can't always help.

    • Posted

      Hi Lisa, thank you for responding to my post and your reassuring words. I'm sorry you have dizziness too, it's horrible. I think you're right about holding your breath that may be a cause, I tend to do that when I'm concentrating or peeling vegetables for instance. I had an ECG done again today which seemed to be ok, but my heartbeat was very fast. I do get anxious visiting the doctors surgery but since I messed around with my meds it tends to beat faster than it used to on any sort of movement. I have another appointment with my doctor next week to check my BP and to discuss meds perhaps for my blood pressure and/or anxiety. I hope you find relief from your symptoms soon.

  • Edited

    Jan and Lisa,

    Jan back in 2016 I decided to go off of my citalopram and then about a month later had all kinds of withdrawal side effects. Then the doctors put me on and off several different medication's within a very short period of time. Then because they couldn't figure out what was going on with me, I was sent for all kinds of tests, and when I say all kinds, I mean all kinds! My blood pressure was terrible which for me was crazy because my family all runs low with the blood pressure. It was the starting and stopping of the medications as well as of course, more anxiety, because of what was going on with my body, and none of the doctors, figuring it out. All of my test came out perfect… The matter of fact, the heart doctor that I went to put me through a bunch of tests and said that if she could show her students a perfect heart, she would show them mine… I'm 62. That was good was really reassuring to hear. And Lisa, I too get the dizzy woozy, feeling kind of drunk or like I have a weird hangover. This doesn't just come on during panic attacks. It is a chronic thing for me that can last for a few days and sometimes a few weeks or months. I am starting to realize that this is a symptom of my anxiety and I'm trying to see what dose of my citalopram will get rid of it! It's so debilitating can you tell me what yours is like and how often you get it? Either one of you?

    • Posted

      That sounds all so familiar to me Shelley, stopping Citalopram and being given a cocktail of drugs which have done more harm than good. I should have known better than to take the advice of just stopping them. I've reinstated citalopram 0.5 mgs, starting very low to see how I get on, sometimes a low dose on reinstatement is best to start off with particularly when I was already down to 5.2 mgs. I've looked at the surviving antidepressant website and this is what they recommend. Maybe it will be worth a visit for yourself.

  • Edited

    So I am back on 2.5mg bendroflumethiazide and 0.5 mg Citalopram for two days. Yesterday was a fairly good day but after I took my diuretic the dizziness/muzzy head came back. I'm not sure if it's the diuretic or my body adjusting to the citalopram. If you are reading this Dr Arthur I would appreciate your thoughts. It seems this all began when my medications were changed, too much swopping and changing maybe?

    This is having a terrible affect on my mental health. My husband is ill too.

    I get dizzy when I sit up from a lying position and also when I lay back down mostly. I also have neck osteoarthritis that seems to be playing up also.

    Thanking you in anticipation.

  • Edited

    Okay, I've read your complaint. I need to inquire whether hypertension was your original complaint or represents a finding by your physician on examination that led to treatment with antihypertensive medications. You ended up at A&E due to elevations in both pulse and BP and this would be an uncommon presentation unless Panic Disorder episodes are occurring.

    It is important to realize that with the exception of only a few specific medications to prevent it, the physiological reactions associated with panic events easily override most all antihypertensive medications and result in symptoms very similar to those that you describe. I'd also like you to specifically describe what you are sensing by the use of the term "dizziness." I ask because people generally have a range of interpretations for this term and often speak of it as interchangeable with lightheadedness. From a clinical standpoint, dizziness is solely the sensation that either you feel as though you are spinning or tilting in a constant manner or that the environment around you is constantly spinning or tilting. I'd also like to know if it is constant or episodic in nature. Causes can range from inner ear disturbances associated with eustachian tube dysfunction to inappropriate influence upon the oculovestibular complex that is responsible for providing constant feedback regarding body position, as well as episodic dizziness associated with Benign Paroxysmal Positional Vertigo that is often observed in persons with significant psychological stress. By contrast, lightheadedness is the sensation that most often precedes syncope, or fainting and is highlighted by diminished vision and hearing that can include unsteadiness.

    It's important to reinforce the comment here that if you are experiencing significant fluctuations in blood pressure and pulse that are accompanied by any other symptoms, then the most likely cause in your instance would be a physiological reaction to panic episodes. Again, traditional antihypertensive medications are ineffective in such instances and can sometimes result in very low blood pressure when it returns to normal status following the panic episode. Sudden decline in blood pressure can indeed produce lightheadedness because perfusion to the brain is slightly diminished and in such instances fainting is not uncommon. I believe this to be the potential where you're concerned because repeated changes across various antihypertensive medications are being deployed in the attempt to achieve normal blood pressure that is absent paroxysmal elevations or spikes.

    You're going to be fine. Temporary spikes in blood pressure are a common feature in persons with Panic Disorder and the readings can sometimes be quite dramatic. While there is a good degree of debate regarding whether the BP spikes are harmful, these patients do not indicate signs of end organ damage of the kind associated with primary hypertension that is resistant to treatment. In your instance, you likely demonstrate benign paroxysmal hypertension, or hypertension spikes that do not result in end organ damage.

    So if you'd like, please respond to my inquiries so that I have a better clinical picture of your experiences that concern you and we'll see if we can help get you headed in the right direction to obtain relief.

    Lastly, I very often close my initial comment by stating that while the internet is an excellent resource for support by others with similar circumstances, it's use regarding medical concerns should always be first fully directed to your primary physician. While I do realize that you indeed spoke of seeking support, the presence of clinical factors present in your instance requires direct interface with your primary doctor to attain relief, which is the main objective. In conclusion, if you wish, please expound upon your condition in relation to my inquiries and I'll provide suggestions that can hopefully result in movement toward a successful treatment solution.

    Best regards

    ADDENDUM:

    Sorry. I failed to notice a second post by you. If after taking the diuretic you feel lightheaded, then it is most probably the consequence of orthostatic response. This likelihood is supported by presence of difficulty upon standing from a seated or lying position. Again, this would commonly arise if antihypertensives are being used to try and overcome variations in BP as a result of panic episodes and subsequently resulting in very low blood pressure at intervals where your BP is normal or even low.

    • Posted

      Thank you very much for replying. i was originally put on bendroflumethiazide around fifteen years ago for border line blood pressure. Over the years I kept taking these as a form of habit, no check ups, I was fine. At the same time I was prescribed 10 mg citalopram f or anxiety. I started to wean off citalopram over a three year period and was down to 5.2 mg. last September. I have had migraines for thirty years, but since my husband had a TIA almost three years ago they became more frequent. He has had other health issues and insomnia which has taking its toll on me, sleepless, upsetting nights. So last September I saw my doctor and asked for migraine preventative meds. I also asked if I could change my blood pressure med because it was border line at this point. I put it down to stress at home. He stopped citalopram and bendroflumethiazide and prescribed amitriptyline, lowest dose and ramipril lowest dose. I was ok for a few weeks but then I was bombarded with headaches, vertigo, lightheadedness, I felt like I was in a zombie state, couldn't function. I went back to doctor and he took me off those and prescribed propranolol lowest dose and losartan lowest dose. I was getting worse after this and, feeling light headed on getting up from lying position to sitting up, I had to sit on the edge of the bed for a few minutes before attempting to stand. My pulse increased on very little exertion. I went to A&E where they did an ECG, BP standing and sitting, pulse all was ok. The doctor from the cardiology dept said there was nothing wrong with my heart and that it could be the changes in medication. I still getting this feeling from lying down to sitting up but not so bad as it was. I also believe I should not have stopped Citalopram cold turkey, I think this has given me protracted withdrawal symptoms. On my last but one visit to my doctor my BP was normal. He took me off all meds and I had to see him the following week to check my BP. At this point my BP was border line again, I asked to go gack on bendroflumethiazide and he suggested I go back on Citalopram also. I am only taking 0.5 mg Citalopram following guidelines on Surviving Antidepressants website which I have great faith in. Today is my third day. I'm getting weird head sensations, headaches, light headedness, tiredness, brain zaps, bad dreams and other symptoms that are familiar with withdrawal but am able to do what is necessary in the home. I am still under a lot of stress at home also, but I am beginning to feel a little better lately and nothing like I was a few weeks ago. I had none of these symptoms prior to last September when I started changing my meds.

      I thank you for taking the time to read this and very much appreciate your views.

    • Edited

      Thank you for taking time to provide a more thorough history. It helps greatly in better understanding the contemporary issues being faced. Since you are starting to feel a little better, I'd suggest remaining precisely where you are with respect to your medication regimen for at least 90 days in order to permit the adjustment period to become well settled. Of course, should you experience a downturn of any kind then most certainly follow your physician's course of action in response.

      The symptoms that you are experiencing are, to the greatest extent, all related to the Citalopram. This is especially true with the sensation described by many patients as "brain zaps," which is actually just a mild attenuation of the occulo-vestibular complex. This system is affected by changes in neurotransmitter regulation from the medication and normally it constantly functions at a rate so high that it is reflexive in nature. When attenuated, if the eyes move it results in a corresponding action by the vestibular complex to make adjustments to the muscle complex of the trunk and limbs to constantly make certain that upright stability is maintained. Due to the slower rate, eye movement results in you being able to detect the result of nerve impulses being directed to the body.

      It is not a sign of anything serious at all and exists more purely as a rather aggravating side-effect of many antidepressant medications. I'll trust that your husband is okay at this point and remember that since he has suffered a TIA, it's important for you both to know his INR, or prothombin time on a regular basis. Very importantly, he should NOT consume foods that provide Vitamin K, which can interfere with any blood-thinner medications he may presently be taking. Many rich, green leafy vegetables like collard greens and turnip greens are very high in Vitamin K. It's important to keep this close in mind as part of his dietary regimen and make certain that his INR values remain stable.

      As for your own circumstances, you're going to be just fine and finding ways to achieve stress reduction, while I know it can be difficult under the circumstances, will help stabilize and maintain your condition as you certainly already know. I wish you both the very best in working to achieve stable health status and let me know how you progress over time.

      Best regards

    • Posted

      Thank you very much for your very reassuring reply and the advice for my husband. It really means such a lot to me. You go into such depths in explaining the reasons for symptoms, makes me wonder why my own doctor doesn't understand the importance of this. You have given so much of your valuable time to myself and others here who are desperately seeking answers. Again, thank you for being here. Kind regards.

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