Question: Hello

I was on fluoxetine (SSRI) for just over 6 years for depression with no major side effects, but I decided to stop the medication in January 2021 as I thought I was now in a good position to deal with my issues drug free ,unfortunately after a year my issues resurfaced so I decided to go back on the medication but for some reason the medication has been causing eye and facial pain on the right side of my face

I have a warm dull ache feeling in my eye ,sometimes in the corner of my eye and what feels like pain at the back of my eye (it is quite difficult to pin point were the pain actually is) and my eye also becomes bloodshot red and I have pulsating sensations in the cheek bone ,temple and the forehead area ,I also developed nasal congestion 

I stopped the medication for 2 weeks and the issued subsided so I tried the medication again and unfortunately the issues reacured, i have tried other SSRIs but they have all so caused the same problems

I have been to my GP but he doesn't know why the medication is causing it 

I have had a CT scan which was assessed by an ENT doctor who ruled out any sinus issues ,and I have also had an eye examinaton with no issues including healthy eye pressure 

I have come to the possibility that serotonin may be the culprit ,and could be some how causing  blood vessel dilation which could be pressing on the nerves ,but obviously I am not an expert so I can't be certain 

Do you have any idea as to what could be happening? 

Thanks you 

Hello Dr

But if the issue is caused by serotonin ,would an SNRI and a TCA not cause the same issue as they are both also serotonin based medications?