Me and my meds ... (it's becoming a soap)

It's now official: the first doctor to prescribe me an antidepressant ever again will be watching the grass from the other side from that moment onwards.

I was on 150mg of wellbutrin xr and 30mg of duloxetin a day. Until recently.

One of the things that bothered me about my meds was having a dry mouth and a lot of damage to my teeth. One tooth in particular was causing me great concern: it had undergone endodontics because a previous dentist did a lousy job repairing a minor hole. I was seeing my dentist at least four times a year for this one because I was constantly chipping it. If a tooth has no sinew left, it supposedly becomes more brittle but this was extreme. Four weeks ago, I lost half of the crown and a piece of the root canal. I have a second appointment next week and that's when I'll know whether my tooth can still be saved.
Upon examining my teeth, the dentist remarked that I probably had an infection on my tongue. Those, just as frequent infections on my gums and the inside of my cheeks and a breath that smelled of dying rats, were - I had always thought - the result of my dry mouth. But thinking back, I remembered that I had woken up with clattering teeth and I was in serious pain because I had bitten a (small) piece off the side of my tongue a week before that. Further inspection learned I had the beginning of damage typical for somebody who is grinding his teeth.

I discussed the matter with my psychiatrist on Friday two weeks ago and he decided to change my medication: I was to take 30mg of duloxetine and 150 mg of wellbutrin on one day and 60mg of duloxetine the other. And that's when problems started.

Years ago, I had been taking 300mg of wellbutrin for a few months and had to stop taking them immediately (not tapering down) because of convulsions. After that, I had been on 60mg of duloxetine which caused severe sleepiness and drowsiness. The initial idea now was that, with half the dose I would not suffer from the side effects.
This time, Saturday night two weeks ago (I had not even skipped my first pill because I wanted to put this in my calendar not to mix things up), I started having convulsions (at intervalls of 2 à 3 minutes, coming in waves with 30 minutes between them). I had the same on Sunday night and did not take any wellbutrin further onwards. I had convulsions until Thursday night.

In the meanwhile, I was on my new dose of duloxetine and started to feel tired and drowsy as I was fearing. It is interesting to note that for years, sports have always been of great help to me. I had taken up cycling again some eight weeks ago and was doing 60 or 70 km, partly off road, on a gravel bike. But for some reason I did no longer have the energy and was sleeping for 12 or more hours a day, I did not recover physically and had a hard time reaching my bedroom on the first floor. I started waking up with painful erections but was unable to get or maintain one when awake. The feeling of constanly being exhausted - rahter than numb as I had felt earlier - is new to me.


I had an appointment with the psychiatrist last Thursday (two weeks after I started to feel so tired). On the way there, at a traffic light, I started to feel nauseous and dizzy. I did not want to block the bicycle lane so I stepped aside and the next thing I remember is that I was lying in the grass, besides my bicycle. After that, things went quickly: the psychiatrist was worried, lowered my dosis and insisted I'd see a cardiologist in the first place.

On Friday morning, I had an appointment with my GP and three hours later I was in the hospital, bypassing all waiting lists. Diagnosis: hypertrophic cardiomyopathy*. I'll be having an number of scans etc. over the course of the next two months and for the time being - and possibly for the rest of my life - I'll be bereft of my most important weapon in battling my depression: my bike. I got the advice (from the cardiologist) to stop taking duloxetine immediately because of the influence on blood pressure and the possibility that arrhythmia caused by my medication is at the root of my problem.


The utter hopelessness I was experiencing until only two months ago ( ) is back. As I had never experienced this kind of exhaustion before I changed my medication, I feel as if there's a link between both events and antidepressants made my future quite bleak: I can't imagine finding a job now, I suppose my dating capital is reduced to 0 etc. etc. ... and - what feels worst to me now - is that, now dying no longer feels as my choice, I find myself clinging to a life that holds no joy whatsoever.


To make matters worse: I started to have convulsions again two nights ago and this afternoon I had some during the daytime for the first time (I am allowed to take the bike for shopping etc and I cycled to the communal garden where I have a small patch) so on top of worrying about my future as a single, lonely, unempolyed, poor heart patient, I've also started freaking out on the idea of being an epileptic.

Pills suck. And since Friday I'm on 3 a day (all heart related) instead of 2 a day. And there's probably more to come.





* thickening of the heart muscle, sometimes genetic, in other cases obesity, high blood pressure and arrhythmia are the main causes.
I know my blood pressure has always been "rather high but still normal [sic]" when I was on duloxetine, all antidepressants I've taken so far have led me to struggle with weight gain.

When you say convulsions what do you mean? Convulsions usually happen when you have a high fever unless you mean you were having something close to a seizure. What happens when you have convulsions? What are your symptoms?

I have no fever, I have been tested for covid-19 and as I was writing this, I got news that is something I don't have (for now).


I've been consulting doctor google last night and I believe seizures are the correct word (although the documentation included with the medications uses the Dutch word "convulsie" which translates to "convulsion), although what I read about myoclonus is probably closer to what I experience. I'm not 100% sure which medical term I'm supposed to use but for the time being, I'll stick to seizure as it seems more accurate than convulsion.


I have these seizures when I go to sleep. They happen the moment I almost sleep: I have a kind of heaviness and tingling building up in my limbs and all of a sudden all muscles in my body (not my limbs) contract. Just once. Sometimes the feeling in my limbs is gone, sometimes it lasts but regardless, the entire cycle starts again: a strange feeling in my limbs building up and then there's the contratction in my muscles.


There is an evolution though: the interval between seizures is becoming shorter (I estimate it was approximately 10 seconds last night) and last night, when I was in bed, the weird feeling in arms and legs never left.
I had daytime seizures for the first time while sitting on a bench after a short and slow bike ride yesterday afternoon. usually getting out of bed, makes the seizures stop and before they never started before I was in bed. All this was no longer the case last night; luckily the intervals were longer when awake.

Around 5AM, the seizures gradually wear off and I manage to get a few hours of sleep between 5:30 and noon. But I'm not confident that window to get at least a bit of sleep will remain.


I have an appointment with my GP this afternoon to discuss my heart condition. I will mention this, but I'm afraid there will be no time to delve into this. Maybe there is, I don't know. All I do know is that this scares me more than my heart condition.

I’m going to be blunt because I’m concerned for you: Wellbutrin lowers the seizure threshold for some people. Sometimes these people are actually genetically predisposed to seizures under the right conditions. Lowering your seizure threshold means it’s easier or more likely to have seizures if something you take triggers them. Maybe it isn’t even the Wellbutrin but because it’s lowers your threshold it could be other medicine or an unknown condition. I’m really trying to emphasize the importance of seeing a neurologist and a doctor aside from your GP. They are not trained in brain issues and at best they may refer you to someone. I don’t know if it’s a cat scan or MRI that you need but you need something beyond a conversation.

Well, that's also how our sytem works in Belgium: you go to the GP and (s)he sends you to a specialist. I have an appointment with a neurologist tomorrow. If I would have gone on my own, I would be on the waiting list for six weeks or more ...

I had an EEG this morning and it showed nothing. At the same time the frequency of what I call seizures (by lack of a better word) went down last night but when I wanted to take a nap at noon (afeter all, I have slept about 8 hours in the last 4 days) and at that moment it was horrible again. I will also have 2 MRI scans of my head in July.


I also have some news about my heart. That is, I don't have news yet, but I know why the cardiologist has not comunicated yet. My liver-values turn out to be way off the charts. My cholesterol and triglycerides are extremely high. All this and my high blood pressure could be a result of the duloxetine but since I have a combination of hypertrophic cardiomyopathy, bad liver values and socio-psychological problems, they are in touch with the university to see whether I should be tested for Fabry's disease (even without the possibility of having this, reading the symptoms and prognosis would make me feel bad).

Interestingly, my blood pressure has been 13-8 for a long time. It was termed high but neither abnormal nor problematic. Strangely, my checkup with the cardiologist started with an ultrasound and a slight thickening of my heart muscle was regarded as "not problematic" while it showed as severe on the ECG.
I have been without duloxetine for four days now and my blood pressure is already down to 12-6.

But really, last July I thought I was going through the worst I would ever experience. Turns out it was all just a walk in the park up to last week.
The only thing I want to do is take my moutainbike and go for a strenous ride in the woods. And I'm not allowed.