Myoclonic Jerks

I began to suffer anxiety with my work in early February of thisyear and a psychiatrist prescribed me Lorezepam (.5mg).  I took 85 pills over the course of 114 days and then stopped on May 30, 2011.  In mid-April I suffered a nerve injury that left me depressed and in pain.

I initially started Citalopram (SSRI) on May 30th and 31st, but then switched to I Cymbalta (SNRI) 30mg (because I heard that it can also help with nerve pain) on June 1 and stopped taking it 6 days later, because I was a little scared of the side effects that were happening to my body.  I stopped cold turkey after the 6 days thinking that it shouldn't be a problem since I wasn't on it that long.  On day 4 of taking Cymbalta I began to notice a muscle twitching in my right inner elbow (lasted for about 2 1/2 weeks) and my left shoulder and abdomen will jerk occassionally when I'm at rest.  However, the most unnerving side effect that I experienced were the sleep jerks that wake me up everytime I go to sleep and this has persisted since June 4th (27 days and going).

I used to get at least 8 hours of sleep a night and now I'm lucky to get 3-5 hours of sleep.  I went to the doctor a week after I discontinuued the medication and I also had high blood pressure for the first time in my life.  One psychiatrist told me that antidepressents can sometimes take weeks or a few months before you stop experiencing symptoms and another psychiatrist told me that it wasn't caused by the Cymbalta and that it was caused by my anxiety.

I just recently went to my family doctor to try to find a way to get some sleep and he prescribed me a beta blocker (attenenol 25mg) and knoplin (.5mg) which seems to have helped in the past two days (8 hours of sleep the other night and 5 hours last night).

My biggest anxiety right now is the possibility that this will be permanent.  Can an SNRI cause permanent damage?

Thank you for any help that you can provide.

Sincerely,
David

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Twitches in the majority of cases are benign meaning they have no consequence and do not cause serious damage or are resulting from serious damage. The twitches can occur focally (one location) or generalized (many locations). Twitches can be related to anxiety/stress, caffeine, and often occur post exercise or muscular over-use. Another type of twitching, which is normal, is called a hypnic jerk. It occurs as we are falling asleep. Again it is exacerbated by stress or caffeine. For these symptoms, the best treatment is to reduce the caffeine intake and/or reduce the stress. If the twitches are bothersome or disabling, medical treatment may be necessary. This will need to be at the discretion of your physician.

If you are concerned about your medications, you should continue to address them with your psychiatrists. However, as I mentioned earlier, anxiety can cause many of the symptoms you describe.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[suzsibs]

I started having myoclonic jerks about 5 years ago, you need to see a neurologist really to find the cause as it may not be anxiety or antidepressants that have caused it. It more than likely is the cause but to be on the safe side get checked out. You need to have MRI of brain and spine, EEG to see if it could be epilepsy and blood tests.
I am taking venlafaxine and have been for over 10 years now, they thought that might be the cause of mine so I stopped taking them for a few months but there was no change in the myoclonus. I have 2 forms, I have spinal myoclonus and startle/reflex myoclonus  I've taken clonazepam for it, that turned me into a zombie, I've taken keppra but that didn't suit me and at the moment I am trying pregabalin to see if that helps.
They have been unable to find a cause for mine so in the meantime I have started a group on facebook called Spinal Myoclonus to find others in the same situation, we are a small group and give support and advice...feel free to join us.
Suz