Is facial numbness a side effect of Amitriptyline?

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Hi Jess. Sorry to hear you have had such a bad time. My GP once told me that I always stop things (medications) too quickly before they have had a chance to work but sometimes it feels like there is no option when the the SE’s are unbearable!

Do you think that perhaps a fresh pair of eyes on your case might help? Different neurologists/GP’s seem to have different preferred treatments and also different boundaries as to how far they will go re: off label prescribing. Apologies if you have already thought of this and discounted it (or tried it). I just feel for you as you are obviously still very much in need of something that you not yet been offered.

I had the worst vestibular migraine I have had for ages just over a week ago. I am taking a mixture of low dose meds Citalopram (10mg), Topiramate (6.5mg), Propranolol (was 20mg now 40mg), Diazepam (2mg at night, and in the day if needed), and Stemetil (5mg when needed), I upped the Propranolol this week (to 40mg), which is all very well but I have to go back to work next week and I can’t seem to stay awake all day.

Anyway, I wish you all the best. Try not to get too stressed about the meds (easier said than done I know), there MUST be something else that will be better than Lexapro for you. Meds are supposed to help!! If they don’t, what is the point?

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@Sarah356 Thanks so much for your support. Yes, I too stop most of the meds too quickly, the SE’s are generally unbearable. And for me, I am currently housebound so sitting around makes me notice them more than if I were working and able to do other things to stay occupied. For instance, when I was first diagnosed my first neurologist (I have been to a few, this first one moved to another state) had me try Zoloft, which I was able to tolerate with no SE’s at all, but I also saw no change/improvement, and I stayed on it 3-4 months!! But I was working and my body didn’t seem sensitive to meds at the time.

I was seen after that by a Hopkins doctor for a one time consult in their vestibular clinic. They gave a nice report of literally all the medicines that they have found can help people with migraines/dizziness. So I am basically working off that list. I do have a new neurologist that follows me more regularly, and she pretty much sticks to the list but has deviated on some of the anti-depressants at times. Her and her entire office staff are a bit bullying though, I have been thinking about changing and trying to find someone more knowledgeable about the dizziness.

I agree that there has to be something better than Lexapro out there for me. I was on Prozac for a few years when this all started, had nausea after the dose for a few days when I first started but it was gone before lunch and was never that bothersome. However I wasn’t able to increase above the initial 10 mg, the 20 mg was too nauseating. It also didn’t help with the dizziness, but I found did help some with the light and sound sensitivity. This neurologist really wants to stick with the SSRI or SNRI categories for now, and my psychiatrist (who is actually prescribing the meds) said SSRI wise that Lexapro should be the easiest to tolerate. I’m honestly too scared of the SNRI class right now.

Wow, you are really on a cocktail of meds! I feel for you, I don’t know how you keep it all straight. But do whatever works, for sure! At least your doctor understands that those low doses are helpful. Most doctors I have encountered would tell me those doses aren’t therapeutic. But for our migraine brains they certainly can be!!

Thanks for the advice on the stress about the meds. I actually think it’s progressed beyond stress and worry at this point, at least as far as anti-depressants are concerned. I had decided that yesterday was going to be my next Lexapro trial, but I woke up earlier than normal and had a 2 hour spell of trembling, intense sweating, and crying and got my body so tired out I knew if I tried the Lexapro I was destined to have SE’s just from the increased pressure my body was under, so I didn’t do the trial. It seems to have turned into more of a “phobia.” It was a strange feeling, I knew what I was doing was unproductive, not healthy, and ridiculous, but at the same time I couldn’t make myself stop. I never had any type of anxiety before all the dizziness started. It’s all very frustrating.

Good luck with work next week. Maybe you will feel more awake and different at work in a different environment from home! Best of luck!

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@Jess09 Sorry to take so long to reply, I know it has been ages. To be honest I haven’t much felt like posting on here, though I have had a look now and again. I have been very tired a lot of the time, restless a bit of it and at work pretty much the rest of it lol. I had a CT scan yesterday so I am hoping to get a once and for all answer to whether anything is physically wrong with my ears. But I am struggling with what I think is abnormal tiredness.

Regarding what you said in your last post: I know I am not a psychiatrist or a neurologist, but surely if the SSRI’s that you CAN tolerate didn’t help, why keep pushing one that you can’t? It doesn’t make sense to me. I think you might be wise to see someone else. Have you ever tried pregabalin? My GP said he would take me off everything I was on and put me on that if it weren’t for the fact it makes you tired. I can’t afford to be tired because of my job but he seemed to think it is good.

How are you doing now? Is the anxiety any better?

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@Sarah356 I am guilty of the exact same thing, i.e. not posting much on the forum. I also look but find it hard to reply. Some days reading this forum is comforting and the support is great, other days some of the stories I read are terrifying. Plus there’s the vision issues, most days I cannot type or read much on the computer.

How are things going with you and your quest for answers about your ears? I feel bad for you about the tiredness, thankfully I don’t really get much fatigue with this. However I am not working currently so that probably has a lot to do with it. I get horrible sleep most of the time but my brain doesn’t seem to always notice, if that makes sense.

You ask a REALLY good question about the SSRIs. I know my neurologist (who after this past Thursday I am no longer seeing) was pushing them because she’s convinced it’s psychogenic in cause. I know 100% that my anxiety is only about specific things and is secondary, and while specific anxiety can make it worse there’s more to this than anxiety. I think the psychiatrist and perhaps the neurologist are both pushing SSRIs because the Xanax works fairly well for me (although now I would need to take more to have the same effect and I don’t want to increase the dose as it’s an addictive med). They think it’s the reduction in anxiety that makes the Xanax work, but I keep telling them that it’s one of the benzos that acts as a vestibular suppressant and I can feel that is why it works so well for me.

I haven’t tried Pregabalin. At one point my psychiatrist suggested it, but I wasn’t sure at the time with the side effects. And to me it seemed like something that would help the headaches more than the dizziness. But, if this dizziness is truly from the headaches then maybe it would help prevent the dizziness too?

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@Jess09 [quote=“Jess09, post:104, topic:13551”]
How are things going with you and your quest for answers about your ears?
[/quote]

Hi Jess. The CT scan showed nothing anatomically abnormal, which I didn’t really think it would. My concern was whether the Cochlea/the tiny hairs etc were being damaged and that wouldn’t show on a CT according to the ENT consultant. He said that would show up on a hearing test (if I was losing hearing). I never did get my hearing test over 8000hz (up to 20000hz). He said he isn’t aware of anywhere in the UK that does it and that most peoples hearing wouldn’t be that good anyway. At least he agreed to do regular hearing tests and we do have a baseline for comparison, so I guess unless I ask for a more specialised referral (which will involved travelling to London or Cambridge) I will have to be happy with that.

I just don’t want to damage my ears through medication. As far as he can tell. no damage has been done but what he can ascertain from the limited investigations he has done is not conclusive imo.

Frustrating, isn’t it. Obviously not being able to balance properly and feeling dizzy is going to cause people to be anxious. Have you found a new neurologist? I decided against pregabalin. My GP suggested that or Gabapentin, (instead of what I am on) however both can cause hyperacusis (only in a small percentage of people, but I have had this before) and also weight gain, and pregabalin causes tiredness.

So I did some research myself and came up with lamotrigine or duloxetine, as neither are known to cause weight gain or hyperacusis. My GP said he would be happier with duloxetine but lamotrigine could be a second line treatement if the duloxetine didn’t help, so I am happy with that. It means coming off citalopram, which I am starting to do.

Anyway, sorry, that is a lot of waffle all about me :slight_smile: How are you?

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That’s correct. CT is best for bone imaging. It wouldn’t pick up soft tissue isssues or issues with pressure. But great came back fine!

Hearing is very sensitive so if you haven’t got any hearing issues then prognosis is probably very good. Vestibular system is more resilient and repairable. You should be hopeful.

In any case I read a paper recently that shows that tinnitus and mild hearing loss are sometimes reversible and can be caused by pressure. If you can address the cause of the pressure, the tinnitus reduces, and the hearing improves. I have a theory that not all hearing loss is caused by virus - that any impact to the integrity of the ear including the maintenance of the right levels of pressure can cause a loss. Its a system like any and it has a transfer function which can be disturbed by injury.

Some day we may get ultra hi-res MRI that may be of more help.

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Hi James. Thanks for your reply. Yes I was pleased there was nothing wrong on the CT, but disappointed at the same time that the thing I was wanting to know about was still unknown.

I don’t have hearing issues now particularly, a slightly blocked feeling rarely, and a kind of soreness/earache on and off which I still attribute to medication. The more serious hearing trouble was when I was on 50mg of topiramate which I clearly cannot tolerate at all, unless I just titrated too quickly. I wanted definitive proof of what damage had been done (or was progressively being done) but I have not been able to obtain that. So I have to research and assess the risks of various medications myself and decide what I am prepared to take.

Regular hearing tests are a good thing but they won’t show a change until the loss is quite bad and by then it would probably be too late to reverse, that is why I wanted the specialised test (up to 20,000hz).

Interesting, I must admit I have looked into medication related ototoxicity (by that I include hearing loss, tinnitus, hyperacusis, ear pain and all of the other possible ear related SE’s) rather than other causes, because that is where my problem stems from. I don’t know why I am more vulnerable to this than others but that just seems to be the case. I guess if a SE is classed as 1% risk, then someone has to be that 1%. And I doubt there are a 100 posters here so it would make sense statistically for there to be only one person here with this issue.

You mean the technology I was hoping for to show the state of my inner ears isn’t even available yet? :rage:

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Well sadly the current ones are just about good enough to allow the doctor to count how many you have, but not much more :smile:

(They are mainly used to rule out neuromas)

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I have just about given up on ENT consultants and neurologists anyway. My own GP is far more helpful and he allows me to try different medications that I research and ask for (obviously only if it makes sense to do so). But he is really cool.