Neurologist Questions

Weird neurological symptoms that started after increasing Sertraline dosage?

I am 20F with diagnosed Hashimotos disorder. I have had this issue since age 8. I have taken Lethothyroxine since. My family has a history of autoimmune disorders including diabetes 2. I have previously contracted lyme disease, was treated with doxy antibiotics and have not experienced new symptoms that I know of since. I believe I have ADHD, possibly with a family history of Autism Spectrum - but no one in my family has been to see a psychologist over this issue. I also have a history of migraines, although they have decreased in intensity with the years, I have been experiencing odd neurological symptoms for approx 2 years now, with no answers. In January of 2022 I began to experience tics. Repetitive jerks of my hands, wrists, legs and shoulders. These would occur every day for about 6 months, to varying intensity. They began directly after switching my antidepressants from Sertraline 50mg to 100mg. I promptly switch to Fluoxetine 10mg, as I assumed the switch had to do with the medication. I stopped taking all medication as of March 2023, including that for my Hashimotos. My tics have not occurred as frequently, but will come back with stress or certain triggers. This summer, June 2023, I experienced several temporary paralysis episodes. My legs weakened and I was unable to get out of bed or walk up the stairs. This would persist for up to 2 hours. I am writing this following one such episode of leg weakness, prefaced by 5 minutes of strong tics. I don't have insurance and am traveling at the moment, so I am unable to go to the doctor to get this checked. I have mentioned my tics to my PCP a year ago when I had insurance and they ignored it. While I understand that you can not give me a diagnosis, a nod in the right direction of what this could be would be appreciated. I do not know if these are purely psychological symptoms or a sign of something more serious, like epilepsy. Thank you.

Female | 20 years old
Complaint duration: 2 years
Conditions: Hashimotos

3 Answers

A difficult situation with the combination of illnesses. What you describe does not suggest epilepsy, unless the repetitive movement is throughout just 1 side of the body (people with epilepsy who have convulsions on both sides at the same time would be unconscious). Other disorders like Multiple Sclerosis and brain tumors would not give you intermittent symptoms such as you described. Leon Rosenberg
You need complete labs and an MRI of the head. many times migraine meds and Prozac, Zoloft can cause serotonin syndrome. but you wrote, that you are not taking any medication. make sure to drink a good amount of liquid, preferably Gatorade, which has electrolytes, till you get your labs.
Do you have OCD ( Obsessive Compulsive tendencies? , I would think you quite possibly do. Tics are quite common on such Frontal Lobe dysfunctions and at times it may have an immune mediated mechanism. You need to sit down with a Neurologist that is comfortable treating such Neuropsychiatric disorders and have an extensive evaluation . As soon as you are done traveling try and get insurance and schedule such.In the mean time try to enjoy your travels and " don't worry obsessively about it" Good luck. Dr. F. Sent from AOL on Android