Posted by Alice Fay on March 6, 2001, at 19:07:45
In reply to Re: Muscle tension and ADs, posted by dj on March 6, 2001, at 10:59:09
> > As DJ has speculated I do believe with myself the muscle problems have come from poor posture etc. After the births of my last two children I didn't do the strengthening exercises as faithfully as I had done after the first one. I >suspect this added to the problem.
>
> And just as there are positive feedback loops there are negative ones with one negative impact contributing to and reinforcing another and another, as posture deters due to neglect because attention is focused more on anxiety, obsessing, depressing or what have you...
>
> My question still remains though about what effects ADs may play in the physical manifestations of these cycles - both positive and negative...???Thanks, willow and dj, for your comments and words of wisdom. When I thought you were talking about "Adrenergics" (AD), guess I got a little carried away thinking about how Effexor has caused these other side effects for me then when I was taking some SSRIs (like prozac). Well, thanks dj for letting me know that ADs means "antidepressants". (And sorry about using the abbreviations HR and BP for heart rate and blood pressure). I feel a little foolish now. Oh well!
I do realize that these medications have different effects on different people. I mean, I did think Effexor was better for me than the SSRIs at first because it seemed to decrease some of the anxiety I felt when on the SSRIs. Though I'm aware that for some people, SSRIs can actually help to decrease their anxiety.
Also, the blood pressure increase and increased muscle tension didn't happen for me until I jumped up to 187 mg. of the Effexor XR. (the heart rate problem may have occurred earlier). So it could very well be that other people don't get these "adrenergic" side effects at all, or else they are more likely to get them when they reach a dose which may be too high for them. Or, if the medication benefits outweigh the annoyance or danger of side-effects, they still may choose to stay on the drug. One other responder said she decided to simply increase her dose of the BP med she was already taking, and that seemed to work for her. I've also heard that Effexor is actually prescribed by some MDs partly because it is supposed to HELP with muscle tension! Well, it certainly didn't do that for me, but maybe it helps for some people at lower doses, or whatever.
So by "adrenergic" I mean the neurotransmitter norepinephrine, which becomes more plentiful in the brain with Effexor. The SSRIs don't have an effect on norepinephrine, so they are not adrenergic. I believe the effexor side effects such as increased heart rate and blood pressure, and probably also increased muscle tension have been attributed to the effects of norepinephrine, and not to serotonin. It is neurotransmitters in the class of norepinephrine (the "adrenergics"), and not serotonin, that are thought to contribute to the "fight or flight" response, which is characterized by all the symptoms above.
I think its great that Effexor has helped you so much, Willow. I might be in bed all day myself if it wasn't for antidepressants. It makes sense that the cause of your muscular pain and tension was from posture and possibly lack of exercise (I was also wondering if muscle tension/pain is a common ailment of people with CFS; I don't know very much about CFS). I too have had problems with one shoulder, an old back injury, and a previous tendency for mild tension in my left calf. However, as I said before, in the last few weeks the tension in this areas became MUCH more pronounced, to the point of becoming quite painful. So I was just wondering whether that might also be the case for you, and whether (or not) you may have reached a dose on the Effexor which might have aggravated your pre-existing muscle tension. On the other hand, if you have some good ways of relieving the tension (sounds like you have), and Effexor is working so well for you, I can see why you might want to keep taking it!
I don't know, I've just had too many side-effects with Effexor, and the BP and muscle ones were sort of the last straw for me. (I have also have had extremely dry mouth, more migraines (another one of Effexor's side-effects), itchiness, trouble getting to sleep, and a few others I can't think of right now.) For me, 150 mg didn't help enough with some of my depressive symptoms, and my body does not seem to tolerate 187 mg well.
So I'm not sure what my psych MD and I will do after I wean from the Effexor. I've recently accepted that my depressions are so severe and close together that I will probably have to be on a "maintenance" dose of whatever AD that ends up working for me. He is thinking of Elavil or amitryptaline, a tricyclic AD, and I need to do a little research on that drug. Have either of you ever tried that? A couple things I know about it are that it can prevent migraines (which I also suffer from)it is good for pain, also it is good for anxiety. I have a vague idea that some people with CFS take it, but maybe I'm wrong.
DJ, as I said I'm new to this site, and am wondering if you also suffer from CFS (I wasn't sure). Anyway, as I said I think probably any antidepressant that increases norepinephrine, particularly at higher doses, could potentially step-up or even trigger the "fight or flight"/muscle tension cycle. I think there might be research supporting this, but don't have the energy or time to look into it further. But I think that any medication/AD that decreases one's anxiety, and as Willow suggested, helps one's sleep, would tend to have the opposite effect. Certainly any drug or activity that relaxes you, I would think would help to relax the muscles. Well, anyway, these are my ideas and theories, based in part on some things that have been studied. Perhaps Cam could shed some light on these ideas.
Hope my long-windedness hasn't annoyed you guys. Take care. I'm looking forward to continuing this conversation, if you so desire!
poster:Alice Fay
thread:55468
URL: http://www.dr-bob.org/babble/20010302/msgs/55766.html