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What Causes Tilted Jaw And Difficulty On Speaking After Stopping Serta?

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Posted on Fri, 27 Jun 2014
Question: Hi, I was prescribed serta 50 mg. I took it for 5 days once a day and then I stopped it because I had involuntory movement on my left lips and face. Now I feel that my jaw is tilted and my neck wants to tilt towards my right. So it feels that the face is tilted. I am also having difficulty in saying some words (I am lisping on some words) because the toungue seems to be touching a different part of my face than normal. Will my speech issues go and will this jaw tilt recover? I also had dry mouth and excess thirst while I was on the medication. I also felt dizzy when I would wake up.
Please tell me if the jaw tilt and the speech issues will be restored and what should I do to get that to a normal state? Please help. This happened 3 weeks back and since then I am not taking anything other than a multivitamin.
doctor
Answered by Dr. Ram Choudhary (1 hour later)
Brief Answer:
evaluation needed, multivitamin is okay

Detailed Answer:
Hi XXXX
Welcome to healthcare Magic!
Some persons do not tolerate these medicine so well as their peers do.
Some dizziness, drowsiness, behavioural issue, speech problems can be explained during the initial period of starting this drug particularly at that doses.
In fact this is the reason most psychiatrists and physicians start this drug as low as 12.5 mg/day and slowly build it up as required and tolerated.
Patient receives 25 mg by day 10 of treatment and 50 mg per day by 3rd week.
The symptoms apparently seem to be related to sertraline upto a week after stopping the drug but having that much symptoms even after 3 weeks of drug discontinuation are abnormal.
If the cause is the drug only you are bound to recover in due course.
if the symptoms are due to the primary disease for which the drug was started then you need to get reviewed again.
If you are aged above 40yrs then you must be evaluated by a local neurologist or a physician for any neurological disease like CVA.
In any case you should be clinically assessed by a physician of your locality and then streamline the further course of management.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ram Choudhary (2 days later)
Thanks for the reply doctor. I am 30 years old and I was given this medicine because I had become very anxious about all health related issues that I had. It all started with a blocked left ear and some colds. After that I had dengue along with sinusitis and nasal bleeding in the left nostril in September 2013. I was diagnosed with mild dengue 4 days after high fever as on the first day of fever the dengue test came negative. After that I recovered well and got back to normal activities withing 3 weeks. Then I observed some hair loss during showering and I got anxious. Then even loss of few strands of hair freaked me out as I read a lot of negative things about hair loss post dengue. So I become anxious in general. After that in end November I continued to have colds and again a spell of fever came in November end. I had a bad throat infection. Was given medication for that as well. I was in general feeling very low mentally about hair and repeated colds and throat infections. I also woke up one night with apparently a few jerk type feeling in the head. Morning I saw some blood coming out from the left nostril so this added to my anxiety. So got a few tests done Also showed to an ENT because of nose bleed (Although now I feel it was not required.) He said I had dry acute sinusitis and so he gave me Augmentin 500 for 5 days. This added to my frustration because more meds. All vitamins were ok and other tests were more or less normal. Only thing is that cholesterol was 270 which was high and that added to my anxiety as I was already feeling I was loosing all my hair. Now I had to control diet as well. I was 66 kgs then so I was not even over weight (Ht 5 ft 9 inches) and I was regular with my tennis till October 2013. Now I was really frustrated and was not able to concentrate on work. All I would do is read about Telogen Effluvium, blocked ear and nasal bleeding. After that in December end and early XXXXXXX 2014 I would get a few jerks now I believe out of anxiety when I was half asleep. I freaked out again as I had read blocked ear with jerks is dangerous. So I went to my GP again and he said we must do a PNS and brain CT scan. Now I had read a lot about CT scan as well and was scared of the radiation and also hair loss and cancer chances so was reluctant to do it. I was ok doing an MRI. But the doc thought that I must do it and so did family. So I did it. Nothing came in it. After that I read about the side effects of CT scan and read a lot of articles how it can cause cataract and impotence. I was planning to get married soon and as soon I as I read all this although the articles said the chances were low my mind started believing in all this. This was in XXXXXXX 2014. Then I started feeling I was not seeing well and I also stopped getting morning erections they way I would get it. I was very upset and then I started hating myself and felt everything is finished. I lost concentration and now I feel I have lost all my skills. I feel I cant get married and get kids. Got my eyes checked and they were Ok. But I still feel everything is dull. I was also getting angry and jealous of the world around me as I believed that I cant live a normal life as I cant see well and that I am impotent. I know somewhere I was overreacting but these thoughts were out of control. I took some auyerveda and stopped as I was not comfortable. So then went back to GP and he gave me Serta 50. After that I got these side effects of involuntary facial movement and feeling of jaw shift and neck tilt after taking it for 4-5 days. Now this has added to my agitation. I was normally very calm. But I dont know after the scan I have gone crazy with these thoughts. I dont like to go out and I dont like to meet friends or spend time with family as I feel that I am finished. I now regret not doing many things such as marriage, travel and many more things as I feel that I have lost everything. I have given up. After taking serta I also have some speech problems as I feel misaligned. I played decent tennis but cant even play at 20% now as I feel I cant run well and my shoulder is misaligned. I know my mind has done this to me but I cant stop the thoughts. I feel responsible for everything wrong happening now and now I feel some more wrong is going to happen because of me.
I dont want to take any medication. Will the side effects that I have go and will I ever feel normal again. I envy everyone happy around me. This is a bad thing but cant stop these thoughts. I feel I will never have a wife and kids as I have gone mad. I feel I will never be able to work the way I used to. I dont want to take medication doctor. Please help.
doctor
Answered by Dr. Ram Choudhary (2 days later)
Brief Answer:
Medicines must under psychiatric care

Detailed Answer:
Hi,
Welcome back to healthcare Magic!
your thought content is certainly abnormal, the recurrence of unwanted thoughts is called obsessive compulsive disorder and another problem with you is the Generalized Anxiety disorder, where usual things are creating too much response. A merely exposure to CT scan has created a trail of thought leading to no marriage, impotence, no children or cataract!
I have seen patients having 4-5 CT scans in a months time and no one had cancer, cataract or impotence in the follow up.
It is like believing that driving a car leads to accident. How often we think of dying in a car accident while driving... Never... so Why to think of accident while in CT scan. Small risk is everywhere!
Even your food can cause food poisoning... Did anyone thought of not eating at all to be safe...No... because that is not practical.
Same is true in your case. Think of common things first, rare things happen rarely.
You need a psychiatric evaluation, Behavioral therapy and of course medication.
You neck issue and the twisted tongue may be a prolonged side effect called Extrapyramidal syndrome or dystonic posturing due to EPS.
It responds to Phenergan drastically, which you can take under supervision of a local psychiatrist.
I hope the advise would be informative and useful for you.
Take Care!

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ram Choudhary (21 minutes later)
Thanks for the reply. Can the dystonic posturing recover without medication as i am scared to take more meds.? Also i stopped serta now a month back and had just 5 tablets. Can the effect last so long. Also can jaw and teeth shift due to tuis condition? While I know all my questions might sound stupid but I cant help asking. Also what are the chances of snapping out of this loop without help? Thanks.
doctor
Answered by Dr. Ram Choudhary (13 hours later)
Brief Answer:
please start treatment under a psychiatrist

Detailed Answer:
Hi XXXX,
Welcome back.
The dystonia will recover fully if it is caused by Serra.
But you should not be adamant for not taking medicines.
You may recover of this on expectant treatment but the psychiatric illness is highly unlikely to do so.
Rather it may cause more troubles if not sorted out and treated as soon as possible.
At times if there is undue delay in such matters then it may be too late for a full recovery.
I hope you will take a more pragmatic approach.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

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What Causes Tilted Jaw And Difficulty On Speaking After Stopping Serta?

Brief Answer: evaluation needed, multivitamin is okay Detailed Answer: Hi XXXX Welcome to healthcare Magic! Some persons do not tolerate these medicine so well as their peers do. Some dizziness, drowsiness, behavioural issue, speech problems can be explained during the initial period of starting this drug particularly at that doses. In fact this is the reason most psychiatrists and physicians start this drug as low as 12.5 mg/day and slowly build it up as required and tolerated. Patient receives 25 mg by day 10 of treatment and 50 mg per day by 3rd week. The symptoms apparently seem to be related to sertraline upto a week after stopping the drug but having that much symptoms even after 3 weeks of drug discontinuation are abnormal. If the cause is the drug only you are bound to recover in due course. if the symptoms are due to the primary disease for which the drug was started then you need to get reviewed again. If you are aged above 40yrs then you must be evaluated by a local neurologist or a physician for any neurological disease like CVA. In any case you should be clinically assessed by a physician of your locality and then streamline the further course of management. I hope the advise would be informative and useful for you. Take Care!