Symptom Conversion Question

[singingmommy]

In October, my husband had a sudden onset of neurological problems.  They started with head and arm tremors and progressed to leg tremors, slowed walking, facial tics (tremors?) and stuttering.  He has no history of anxiety or depression.  He has no history of medical problems.  He never takes sick days and rarely gets even the common cold.  He has had no major life changes, no traumas, etc.  He's 36.  We have 2 young children and another to arrive in 3 months.  Until now, we've been enjoying a happy phase of our lives.  After numerous tests that proved inconclusive, our neurologist has diagnosed him with Symptom Conversion.  He prescribed two anti-depressents and bio-feedback and we have been waiting for improvements for two months.  In the meantime, my husband is unable to work or drive which have been difficult adjustments for us all.  Last week, I phoned our neurologist to tell him that while we've had days that seemed better than others, his symptoms continue and we've begun to wonder if we need to look further for medical advice.  I have approximately one month left in my pregnancy for air travel and asked for his expert opinion.  He then told me that we needed to give my husband more time for treatment, told me to double his dose on one of the meds and come back after the baby is born. I am a little bit uncomfortable with this treatment plan.  Can you tell me how long that an individual needs to be on anti-depressants before improvements begin?  Also, should he be on anti-depressants at all without any history of anxiety or depression?  Do we need a second opinion?  My fear is that he may have another problem that is not being treated properly.

[Roger Gould, M.D.]

I would recommend that you do just that, get another neurological opinion. The antidepressants should have helped by the end of the first month.  Sometimes neurological lesions are hard to pinpoint, but if symptoms are sudden in onset and persist, you should keep looking aggressively.  You can also explore the conversion diagnosis with a psychiatrist who treats people with talk therapy rather than medications.  If after several consultation visits the psychiatrist does not think it is a conversion reaction, you will know to be more  persistent in your neurological exploration.  If it turns out to be conversion, you will be getting the right treatment.

[rodymu]

Dear Singing Mommy,

It seems your husband's neurologist doesn't know what he is doing. Why did he prescribe the anti-depressants? Is your husband really depressed? Did he become depressed because of the situation?

I have been diagnosed with conversion disorder too and my psychiatrist prescribed 150mg of Clomipramine each day. This is a classic anti-depressant whcih is prescribed for patients who are not depressed but suffer from conversion symptoms.

It was actually recommended by a neurologist in Germany and I advised it to my shrink. When I returned to the neurologist one year later, it was pointed out that my shrink prescribed a dosis that was way too high. Also, she sometimes tested my blood to check whether the medicine was working or whether a higher dosis was needed.

According to the neurologist, this check is only relevant if one takes the medicine for depression. In case of conversion, a much lower dosis should already do the job! So, I guess your neuro's advice to simply double the dosis is a bit unprofessional.

I did psycho therapy for more than a year but didn't come across any subconcious conflicts. I discussed all my life-events and emotions but I don't feel it made me any wiser.

According to my neurologist, it would be just time-consuming to indulge in more psychotherapy. He says that it is extremely difficult for both the patient and the therapist to pinpoint relationships between the symptoms and how the patient feels mentally.

The only good news is that eventually the symptoms will subside. It's a matter of time. For some it takes years, for others just months.

Rody

[LaNell]

When I was a teenage and sometimes later in my 20's, I used to have a strange phenomena that I can only describe like this:  I would be looking at something and then quite suddenly it would be VERY FAR away, in the distance, and there isn't any pain that I rememer either, just as if it were a picture that suddenly became smaller and far away.  Does this make any sense to anyone?  I'm a senior citizen now and I haven't experienced that "far away" thing for many years BUT, (there's always a but isn't there?) I also had Migrain headaches in earlier years (age 20's, 30's) that were devastating and here's that BUT, now, today, I can get that jagged line/migrain thingy that I see in my eyes, that I had years ago when it hurt, but NOW, I just get the jagged line that within about 5 min. just goes away and NO PAIN.  This may sound silly, but I was just curious if this is any sort of neurological/brain thing or not? I HAVE been having tingling in my left arm & hand for a couple of months now, but I THINK it's because of my rehumatoid arthritis but then again, I've had my usual blood tests and that was just fine.  And it's not heart either.  I was wondering if I have a brain/neurological reason to go see a Neurologist? Thanks for listening.

[deb723]

I am currently doing research for an upcoming book which deals with the side effects and withdrawals people have experienced from Effexor XR and other (like) anti-depressants. I am interested in receiving any information current or former users would like to share concerning their experiences with these drugs. Please email me @:
beach-***@****
and thanks!
deb