Side effects of Zoloft and Mianserin ??

Hi

3 months ago I started to have muscle twitches. After a couple of weeks it started to make me anxiuos and I was convinced that I had some terrible disease, like ALS. I went thru a normal neuro exam and everything seemed OK. The neuro suggested that the twitches could be from stress or anxiety . This sounded reasonable since I had a really bad year last year. He prescribed 50 mg Zoloft/day. After 2 weeks I returned because I had started to have problems with headache and waking up alot during the night. The neuro then added 10mg Mianserin to be taken an hour before bedtime and also said that if the headaches and sleeping got better I should increase the Zoloft dose to 100 mg. The following 2 weeks I stayed with 50 mg/day and added the Mianserin. Both the headaches and the sleeping got better and I also started feeling less anxious. The twitching also decreased. I then increased the Zoloft dose to 100 mg/day but after 2-3 days I started to have a feeling of thightness in my chest and throat as if it was hard to breathe but if I try to take a deep breath and don't have any problem doing so.  The twitches also increased again and got worse than before. This has raised my anxiety level again and since I have to wait at least a week for a new appt. I have some questions. Could this be sideeffects from increasing the Zoloft dose ? Could it be due to the Zoloft/Mianserin combination ? or is it more likely that this is another anxiety symptom ?
Do You think there would be a problem going down to 50 mg/day of Zoloft again ?

Thanks for your time

/Claes  

[HFHS MD - RG]

Zoloft which is an antideprant that increases the sorotninlevel in your brain. Mianserin, is an older type of antidepressant that belongs to the tetracyclic family is a selective 5HT2 antagonist that also causes an increase of serotonin level in your brain. Research shows that increasing levels of serotonin in the brain treats the symptoms of depression.

However, too much serotonin may cause a condition called Serotonin Syndrome. The symptoms of the serotonin syndrome are: euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, mental status changes, shivering, diarrhea, loss of consciousness and death.

The optimal treatment for the serotonin syndrome is discontinuation of the offending medication or medications, offer supportive measures, and wait for the symptoms to resolve. If the offending medication is discontinued, the condition will often resolve on its own within a 24 hour period.

Therefore it is recommended that Zoloft, Prozac, Paxil, Luvox, Serzone, etc. not be used concurrently with each other or any other serotonergic drugs.

[Dale]

MY WIFE HAS HAD A PROBLEM WITH ANXIETY AND DEPRESSION FOR SIX OR SEVEN YEARS. THE FIRST DOCTOR HAD HER ON TRAIZONE WHICH DIDN'T HELP MUCH. SHE WENT THROUGH TREATMENT IN A MENTAL CLINIC THREE TIMES AND THEY DONT SEEM TO FIND THE RIGHT COMBINATION OF DRUGS TO HELP HER. NOW SHE IS ON EFFEXOR 75MG AND SERZONE 300MG. HE JUST TOOK HER OFF PAXIL 60MG. SHE'S BEEN HAVING ALL KINDS OF SIDE EFFECTS WITH THESE MEDICINES, DRY EYES, DIALATED PUPILS SO SHE CANT STAND BRIGHT LIGHTS,ITCHING,CONSTANT MOVEMENT OF MOUTH AND FOOT. I DONT KNOW HOW TO HELP HER. HER DOCTOR SAYS SHE IS A COMPLEX CASE.SHE STARTED OUT YEARS AGO ON MELLERILL, AND TOOK THAT FOR MANY YEARS. SHE STARTED HAVING MOVEMENT OF HER FOOT AND FINGERS, AND MOUTH. THAT'S WHY THEY CHANGED HER TO THE OTHER MEDICINES. NOTHING SEEMS TO HELP. SHE FEELS SHE CANT DO ANYTHING AROUND THE HOUSE. SHE HAS HEADACHES, DRY MOUTH AND EYES, AND JUST DOESN'T FEEL LIKE DOING ANYTHING. IS THERE AN ANSWER TO HER PROBLEM? WOULD APPRECIATE YOUR HELP THANKS. DALE