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What Causes Uncontrollable Jerky Movements After Having Antidepressants?

Posted on Mon, 8 Sep 2014

Question: What is wrong with me? I am taking valium 5mg once at night, zoloft 200 mg once at night , and doxepin 200 mg once at night. I am having uncontrolable jerky movements with my jaw and hands. Its near impossible to talk, what is wrong?

Answered by Dr. Jonas Sundarakumar (1 hour later)

Brief Answer:
Likely to be a side effect of the medication...

Detailed Answer:
Hello and thanks for writing in.

From the description of your symptoms, it appears that the uncontrollable jerky movements (dystonic movements) that you are experiencing are likely to be due to side effects of the antidepressant medication. 200mg of Zoloft (Sertraline) and 200mg of Doxepin are quite high doses and when combined, these medication can result in side effects like this.

I would advise you to go to the emergency department as early as possible and have yourself examined properly. This is urgent because having such involuntary movements could mean that there is a risk of having seizures also.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (4 minutes later)

What is the risk of seizures?

Answered by Dr. Jonas Sundarakumar (6 hours later)

Brief Answer:
Risk is dose-dependent...

Detailed Answer:
Hi,

Tricyclic antidepressants, which includes Doxepin can have a risk of lowering seizure threshold with high doses. Especially, when combined with another antidepressant, there can be a risk of seizures. Though there is no data available on the exact percentage of risk, it is known that the risk is dose-dependent. Also, considering the fact that you have already developed some involuntary jerky movements, you need to be very cautious.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (1 hour later)

So if I stop the zoloft I shoud see these jerky movements go away?

Answered by Dr. Jonas Sundarakumar (13 hours later)

Brief Answer:
Gradual tapering down the dose is advisable...

Detailed Answer:
Hi,

Abruptly stopping the medication is not advisable as it could result in withdrawal symptoms or rebound anxiety. Among the two antidepressants, I think it would be a better idea to reduce Doxepin gradually and stop it, since Doxepin is the one with more risk of adverse effects.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar