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Does Coaxil Cause Sore Throat And Stuffy Nose?
Question: Hi
I am a women, age 33.
In August, September 2014
Using antidepressant Coaxil first time in my life (difficult life situation) for 2 months.
25.-30. September
I had stopped using Coaxil - felt a bit dizzy etc.
Got a flue like sore throat and strong headache that lasted for approx 3-5 days (not typical for me, I don't have headaches often). Was using different pills - Ibumetin, Imigran (a migrine pill) - normally they work, this time they did not.
Also, some times around that time, a refridgerator-like sound started in my ears (more in left ear, less in right ear). Tinnitus?
January 2015, today
Refridgerator-like sounds still in my ears (already 3 months).
I also had a flue (sore throat, stuffy nose) at the end of December.
What worries me the most is that I get headaches very easily now - by having a conditioner on the left hand side, I got strong nerve pain above my left eye and the entire left side of my head; when just sitting by a window on the riht hand side, I get a nerve pain above my riht eye and the entire riht side of my head; when going to swimming in indoor pools with wet hair, I got headache and pain in the nerves above my eyes again. Does that indicate some sort of nerve damage or inflammation in my head as a result of a) Coaxil or b) interactin of Coaxil and one of the pain killers (Ibumetin, Imigran) c) one of the flue like illnesses d) as a result of the Patulous Eustachian Tube Dysfunction in my left ear http://hearing XXXXXXX edu/care/adult/diseases/tube_dysfunction.aspx that I am leaned to live with BUT what I am using a lemon juice for to reduce the suffering (maybe has affected a nerve)?
I was visiting an ear doctor - hearing is very good and ear looks fine.
Family doctor thinks that if something, it is related to nerves.
The psychologist said that one of her other patients using Coaxil is complains the similar problem.
Health in general is good, blood samples etc are good. I am having a pain in the nerve above my righ eye already for years when I get a bit cold (very unpleasant, would like to find cure for that as well), no doctor has within 5 years known what to do. But that is about it. In general am healthy, happy, live a good life.
I am hoping that You may be able to give Your opinion, which is much appreciated. Thank you.
I am a women, age 33.
In August, September 2014
Using antidepressant Coaxil first time in my life (difficult life situation) for 2 months.
25.-30. September
I had stopped using Coaxil - felt a bit dizzy etc.
Got a flue like sore throat and strong headache that lasted for approx 3-5 days (not typical for me, I don't have headaches often). Was using different pills - Ibumetin, Imigran (a migrine pill) - normally they work, this time they did not.
Also, some times around that time, a refridgerator-like sound started in my ears (more in left ear, less in right ear). Tinnitus?
January 2015, today
Refridgerator-like sounds still in my ears (already 3 months).
I also had a flue (sore throat, stuffy nose) at the end of December.
What worries me the most is that I get headaches very easily now - by having a conditioner on the left hand side, I got strong nerve pain above my left eye and the entire left side of my head; when just sitting by a window on the riht hand side, I get a nerve pain above my riht eye and the entire riht side of my head; when going to swimming in indoor pools with wet hair, I got headache and pain in the nerves above my eyes again. Does that indicate some sort of nerve damage or inflammation in my head as a result of a) Coaxil or b) interactin of Coaxil and one of the pain killers (Ibumetin, Imigran) c) one of the flue like illnesses d) as a result of the Patulous Eustachian Tube Dysfunction in my left ear http://hearing XXXXXXX edu/care/adult/diseases/tube_dysfunction.aspx that I am leaned to live with BUT what I am using a lemon juice for to reduce the suffering (maybe has affected a nerve)?
I was visiting an ear doctor - hearing is very good and ear looks fine.
Family doctor thinks that if something, it is related to nerves.
The psychologist said that one of her other patients using Coaxil is complains the similar problem.
Health in general is good, blood samples etc are good. I am having a pain in the nerve above my righ eye already for years when I get a bit cold (very unpleasant, would like to find cure for that as well), no doctor has within 5 years known what to do. But that is about it. In general am healthy, happy, live a good life.
I am hoping that You may be able to give Your opinion, which is much appreciated. Thank you.
Brief Answer:
Coaxil not a likely cause.
Detailed Answer:
I read your question and I understand your concern.
I must confess that where I live Coaxil (Tianeptine) is not present so I don't have a personal experience with my patients. It is a type of antidepressant which is mostly present in Eastern European countries and not in most of Western Europe and US. I know of it due to exchanges I have had with colleagues of mine from Lithuania, Czech and Russian Republic which had good experience with it. Being a neurologist and dealing with this class of drugs that intrigued me into researching more about it, both regarding efficacy as well as side effects..
While anti-depressants are often used to prevent headaches at times alteration of neurotransmitter balance can at times exacerbate it. However looking at the localization of the headache and especially the fact that you have long interrupted the drug I don't think that the use of Tianepine can be really blamed for that. Also it does not cause tinnitus, there are some other drugs which do, but it's not among Tianepines side effects and nothing in its mechanism of action suggest it to be a new unknown side effect of it. There are no such interactions with Ibumetin or Imigran either.
If it wasn't for your ENT visit, considering the exacerbation after a flu like syndrome, with tinnitus I would have put middle ear infection as the first possibility. However you say ENT excluded that and I guess other ENT related causes of headache like sinusitis.
Another less likely cause for one sided headache with tinnitus could also be temporomandibular joint dysfunction, that might also have been checked by your ENT perhaps.
Patulous eustachian tube would cause tinnitus but not headache, also other signs like autophony (the abnormal perception of your own breath and voice sounds), tinnitus would also be synced with respiration.
Neurological causes related to brain lesions, unless you have other symptoms like vertigo, hearing loss are not likely. If symptoms persist a neurological exam to check for neurological signs and MRI could be scheduled, although as I said if you don't have those other symptoms I don't expect it to reveal any neurological abnormality.
Stress and anxiety with tension type headache, a primary headache (meaning with no identifiable cause - triggered and exacerbated by stress) could well be the cause though, once other causes are excluded. In that case treatment is with relaxation techniques coupled with over the counter pain killers of the Ibumetin type are the main treatment. If chronic headache persists another antidepressant like Amitriptyline could be tried at the lowest possible dose to avoid side effects like those you had with Tianeptine.
I remain at your disposal for further questions.
Coaxil not a likely cause.
Detailed Answer:
I read your question and I understand your concern.
I must confess that where I live Coaxil (Tianeptine) is not present so I don't have a personal experience with my patients. It is a type of antidepressant which is mostly present in Eastern European countries and not in most of Western Europe and US. I know of it due to exchanges I have had with colleagues of mine from Lithuania, Czech and Russian Republic which had good experience with it. Being a neurologist and dealing with this class of drugs that intrigued me into researching more about it, both regarding efficacy as well as side effects..
While anti-depressants are often used to prevent headaches at times alteration of neurotransmitter balance can at times exacerbate it. However looking at the localization of the headache and especially the fact that you have long interrupted the drug I don't think that the use of Tianepine can be really blamed for that. Also it does not cause tinnitus, there are some other drugs which do, but it's not among Tianepines side effects and nothing in its mechanism of action suggest it to be a new unknown side effect of it. There are no such interactions with Ibumetin or Imigran either.
If it wasn't for your ENT visit, considering the exacerbation after a flu like syndrome, with tinnitus I would have put middle ear infection as the first possibility. However you say ENT excluded that and I guess other ENT related causes of headache like sinusitis.
Another less likely cause for one sided headache with tinnitus could also be temporomandibular joint dysfunction, that might also have been checked by your ENT perhaps.
Patulous eustachian tube would cause tinnitus but not headache, also other signs like autophony (the abnormal perception of your own breath and voice sounds), tinnitus would also be synced with respiration.
Neurological causes related to brain lesions, unless you have other symptoms like vertigo, hearing loss are not likely. If symptoms persist a neurological exam to check for neurological signs and MRI could be scheduled, although as I said if you don't have those other symptoms I don't expect it to reveal any neurological abnormality.
Stress and anxiety with tension type headache, a primary headache (meaning with no identifiable cause - triggered and exacerbated by stress) could well be the cause though, once other causes are excluded. In that case treatment is with relaxation techniques coupled with over the counter pain killers of the Ibumetin type are the main treatment. If chronic headache persists another antidepressant like Amitriptyline could be tried at the lowest possible dose to avoid side effects like those you had with Tianeptine.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Prasad
Hi,
..and thank you for your thorough reply and devotion.
Few more questions:
1. are there any cutting edge treatments for tinnitus nowadays in case it gets worse? Could you please proovide some URL-s for reference? I will try and forget about the probleem now, but would like to know plan B in case it gets unbearable.
2. the nerve pain above the eyes (which now also expand to my head in case I get a bit cold) have shown some response to warmth (e.g. warm spoon, tea bag) - this has been my only escape remedy so far, while the nerve pain above my left eye (without ahy headache) has occurred already for 5 years at least in the situations like e.g. I have a back ache (bad chair), too much work with computer (eyes are checked, nothing wrong) or as noticed now, when using air conditioning.
2014 it expanded a bit - I felt it also near my nose bone and riht side of my head.
Although none of the doctors has given me any concrete assistance, there was one finally (ENT) who thought - it must be a nerve.
My question is that, is there any kind of solution at all for that kind of nerve pain above my eye (surgical or non-surgical - preferred) to get rid of it? It is not a migrene, I know that (have had that twice in early 20-s), however, it gives a very disturbing sendse, avoids me working with computer, use lights, looking into peoples eyes - all I want to do is to look into distance or close my eyes. Has been very disturbing at work days, but no solution has been provided so far.
Thank you again, best regards.
..and thank you for your thorough reply and devotion.
Few more questions:
1. are there any cutting edge treatments for tinnitus nowadays in case it gets worse? Could you please proovide some URL-s for reference? I will try and forget about the probleem now, but would like to know plan B in case it gets unbearable.
2. the nerve pain above the eyes (which now also expand to my head in case I get a bit cold) have shown some response to warmth (e.g. warm spoon, tea bag) - this has been my only escape remedy so far, while the nerve pain above my left eye (without ahy headache) has occurred already for 5 years at least in the situations like e.g. I have a back ache (bad chair), too much work with computer (eyes are checked, nothing wrong) or as noticed now, when using air conditioning.
2014 it expanded a bit - I felt it also near my nose bone and riht side of my head.
Although none of the doctors has given me any concrete assistance, there was one finally (ENT) who thought - it must be a nerve.
My question is that, is there any kind of solution at all for that kind of nerve pain above my eye (surgical or non-surgical - preferred) to get rid of it? It is not a migrene, I know that (have had that twice in early 20-s), however, it gives a very disturbing sendse, avoids me working with computer, use lights, looking into peoples eyes - all I want to do is to look into distance or close my eyes. Has been very disturbing at work days, but no solution has been provided so far.
Thank you again, best regards.
Brief Answer:
Nerve pain not very likely.
Detailed Answer:
Thanks for getting back to me.
Regarding you first question about tinnitus: first of all if a cause is found it has to be addressed. There are not any new modern age treatments for tinnitus itself, if a cause is identified and can be corrected that would be hoped to remove tinnitus as well.
So if symptoms persist without any ENT finding to look for rarer causes an MRI is usually performed.
If at the end of the day no cause is found then antidepressants like Amitriptyline can be tried (which conveniently is used also for tension type headache prevention).
As for URL from patient directed sites I have found the Mayo clinic one to be the most clearly and understandably written. Wikipedia as obvious as it may seem has some good articles as well. Link for tinnitus (also included webmd):
http://www.mayoclinic.org/diseases-conditions/tinnitus/basics/definition/con-0000
http://www.webmd.com/a-to-z-guides/understanding-tinnitus-basics
Coming to the second question, regarding the nerve pain suggested by the ENT doctor, I thought about that when I gave the first answer, but from your description didn't look very likely. There are several types of nerve pain, like trigeminal neuralgia or trigeminal autonomic cephalalgias group. Didn't look likely because they usually are of a short paroxysmic nature while your headache looked more persistent, constant once it started.
Trigeminal neuralgia are stabbing, lancinating pain episodes lasting only for some seconds.
Trigeminal autonomic cephalalgias are of different types, they usually have marked autonomic phenomena like conjunctival injection, lacrimation, nasal congestion, rhinorrhoea, eyelid swelling which you don't mention. There are several types, the most common are cluster headaches with attack lasting 5-180 min, occurring in clusters, periods of several attacks a day. Another type is paroxysmal hemicrania where the attacks are even shorter. There are other ones less common and even shorter in attack duration.
http://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/basics/definition/con-0000
http://en.wikipedia.org/wiki/Trigeminal_autonomic_cephalalgia
http://www.mayoclinic.org/diseases-conditions/cluster-headache/basics/definition/con-0000
http://www.patient.co.uk/health/tension-type-headache-leaflet
From your description it looked more like a tension type headache as I said before. However if I was wrong in my assumption and the episodes are of such short lancinating character, or associated with the mentioned signs, of course give me some more info on duration, frequency and associated symptoms and other types of headache could be considered and preventive treatment discussed accordingly. Surgical treatment can at times be considered in trigeminal neuralgia but medical treatment is always tried first.
I hope to have been of help.
Nerve pain not very likely.
Detailed Answer:
Thanks for getting back to me.
Regarding you first question about tinnitus: first of all if a cause is found it has to be addressed. There are not any new modern age treatments for tinnitus itself, if a cause is identified and can be corrected that would be hoped to remove tinnitus as well.
So if symptoms persist without any ENT finding to look for rarer causes an MRI is usually performed.
If at the end of the day no cause is found then antidepressants like Amitriptyline can be tried (which conveniently is used also for tension type headache prevention).
As for URL from patient directed sites I have found the Mayo clinic one to be the most clearly and understandably written. Wikipedia as obvious as it may seem has some good articles as well. Link for tinnitus (also included webmd):
http://www.mayoclinic.org/diseases-conditions/tinnitus/basics/definition/con-0000
http://www.webmd.com/a-to-z-guides/understanding-tinnitus-basics
Coming to the second question, regarding the nerve pain suggested by the ENT doctor, I thought about that when I gave the first answer, but from your description didn't look very likely. There are several types of nerve pain, like trigeminal neuralgia or trigeminal autonomic cephalalgias group. Didn't look likely because they usually are of a short paroxysmic nature while your headache looked more persistent, constant once it started.
Trigeminal neuralgia are stabbing, lancinating pain episodes lasting only for some seconds.
Trigeminal autonomic cephalalgias are of different types, they usually have marked autonomic phenomena like conjunctival injection, lacrimation, nasal congestion, rhinorrhoea, eyelid swelling which you don't mention. There are several types, the most common are cluster headaches with attack lasting 5-180 min, occurring in clusters, periods of several attacks a day. Another type is paroxysmal hemicrania where the attacks are even shorter. There are other ones less common and even shorter in attack duration.
http://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/basics/definition/con-0000
http://en.wikipedia.org/wiki/Trigeminal_autonomic_cephalalgia
http://www.mayoclinic.org/diseases-conditions/cluster-headache/basics/definition/con-0000
http://www.patient.co.uk/health/tension-type-headache-leaflet
From your description it looked more like a tension type headache as I said before. However if I was wrong in my assumption and the episodes are of such short lancinating character, or associated with the mentioned signs, of course give me some more info on duration, frequency and associated symptoms and other types of headache could be considered and preventive treatment discussed accordingly. Surgical treatment can at times be considered in trigeminal neuralgia but medical treatment is always tried first.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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