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Monday, September 17, 2012

Reasons of blurred vision and profuse sweating

After taking sertraline, I am getting blurred vision frequently. Sometimes cannot read the fine print and labels on the shopping items. Also cannot work long time seeing the laptop monitor. Also, I get muscle fasciculation or muscle twitch on my eyelids and sometimes on muscles around the eye.

From Wikipedia, I got the following information.

The iris contains two sets of muscles:


The muscles regulate the amount of light entering the eye. The sphincter pupillae is stimulated through muscarinic receptors by the parasympathetic nervous system. The dilator pupillae is stimulated through noradrenergic receptors by the sympathetic nervous system.

Alterations are produced by muscarinic antagonism in two muscles: inhibition of iris sphincter muscle causes mydriasis, while relaxation of ciliary muscle produces ciclopegia.

It may be possible that, sertraline might have decreased acetylcholine in the eye muscles possibly due to its increased dopaminergic activity. However, I did not observe this effect with bupropion. So, the another possibility is that sertraline might have decreased noradrenaline which might have caused the imbalance in eye accommodation. I also feel less sweating with sertraline which I did not observe with fluoxetine or bupropion. Hence, in my case, profuse sweating might be the due to increased noradrenaline levels and blurred vision is probably due to decreased noradrenaline levels. Further research is required on this.

Update on 6 October 2015:

Effect of folic acid and methylcobalamin

During the last few months, I was having blurred vision after lunch and even after mild exercises. I was not able to read fine print and medicine labels for most of the time. I was not able to see computer monitor for long time and work. I took folic acid 1.25 mg and methylcobalamin 250 microgram and vitamin C 500 mg for few days. This combination almost cured my blurred vision. Now, I am able to read fine print (but not very fine print in the medicine labels), see computer monitor for long time and work. No blurred vision. It appears that I may have some fault in the absorption or processing of folic acid or cobalamin. I need to explore it further. After taking methylcobalamin, my finger pain also reduced very much suggesting the fault in processing of cobalamin.

Thursday, September 13, 2012

Effect of Sertraline

After stopping fluoxetine, even though I felt more energetic and less depressed, I felt more irritability and gasping for breath which affected my lecturing ability.

So, I checked with a doctor about this. The doctor prescribed sertraline 50 mg once daily along with asenapine 5 mg (sub lingual once daily) and olanzapine 10 mg once daily.

I started with sertraline first at the night time after dinner before going to bed. Initially for the few days, I felt good mood and energetic. So, I added asenapine 5 mg. I felt dizziness, slurred speech, heavy discomfort and internal unrest. So the next day, I stopped asenapine. I did not start with olanzapine because I was afraid  of extrapyramidal side effects, possible weight gain and risk of diabetes.

So, I decided to continue only with sertraline 50 mg once daily at the night. After 3-4 days, diarrhea occurred. Everyday, two times. Especially, after waking up in the morning, severe urgency to defecate occurred with unable to control feeling. However, this was not like normal diarrhea and somewhat different.  The diarrhea was difficult to tolerate especially during the working hours in the office. And also, some feelings of compulsory activity (eyesight following the lines of an object, eyesight following a symmetrical lines in an object) and internal unrest occurred.

So, I decided to reduce the dose to half tablet (~25 mg) and change the timing to morning. So, for the last two weeks, I took the half tablet in the morning. No diarrhea occurred the next day and no more diarrhea. And the compulsory feelings and internal unrest also got reduced much. However, after one week, sluggishness and slowness of mind happened. I was unable to motivate myself to do the things which I had planned earlier. I also had stomach bloating and sleep debt. I felt there is something wrong with the food I am taking. I used to take coffee with milk powder and sugar (3 cups of coffee per day, morning before breakfast, after lunch and in the evening around 7.30 pm). So, I decided to stop the milk powder. The next day, I felt more energetic, more clear minded, less stuttering during the lecture. I think, the milk peptides from the milk powder may increase the GABA levels and might have caused this. I need to check this for few more weeks.

Overall, the effect of sertraline can be summarized as follows:

Sertraline 50 mg Sertraline 25 mg
Effects on anxiety Reduced general anxiety and reduced anxiety of stuttering Reduced general anxiety and reduced anxiety of stuttering
Effects on depression No low mood at all; very bright mood No low mood but some lethargy is there
Effects on stuttering and voice Mild stuttering; reduced loudness of voice; Unable to make a good lecture Very mild stuttering; Able to deliver a good lecture; moderate loudness of voice < that achieved with fluoxetine
Effects on motivation Good motivation Reduced motivation with milk powder in coffee. After stopping the milk powder, the motivation seems to be slowly onsetting.
Effects on telephonic conversation Vocal blocks happened, unable to ask questions less vocal blocks and fairly smooth conversation
Effects on affection and social life Very good affection towards the wife and children Average affection towards wife and children. Seems to be improving after stopping the milk powder.
Effects on sleep Slightly increased sleep duration; but after waking up felt energetic and motivated to engage in works Slept for more hours; sleep debt occurred; not refreshing after waking up; seems to be improving after stopping the milk powder.
Effects on libido and sex Increased libido and erections; no premature ejaculations Decreased libido
Effects on eye vision Blurred vision occurred especially when taking multivitamins Supradyn recharge Not much blurred vision; seems to be improving after stopping the milk powder.
Effects on driving Apparently no effect Apparently no effect
Effects on body temperature and sweating Felt less heat in the body; felt cold; Significantly reduced sweating No feelings of coldness in the body; Significantly reduced sweating
Other effects Internal unrest; Diarrhea No diarrhea; no internal unrest


I need to monitor the motivation levels and quality of sleep after stopping the milk powder.

Update on 31/12/2012

Eyelid Twitching

After I stop the milk powder, my energy level increased and motivation levels became normal. However, my stuttering was there on and off. So, I tried, L-methylfolate 7.5 mg tablet in the night. After few days itself, my mood flattened. After two weeks, I developed eyelid twitching. Both my eyelids started twitching involuntarily. This twitching occurred during the wakeful period. During sleeping, it did not occur. It was really embarrassing while talking to others. During the twitching, the upper eyelid moved horizontally. Sometimes, lower eyelid also twitched horizontally. Then, I stopped taking sertraline and L-methylfolate. The eyelid twitching gradually reduced in another two weeks. I realized that it is the effect of L-methylfolate when combined with the sertraline and possibly due to the increased dopamine at the basal ganglia which controls the eyelid movement. During this time, I took Ginkgo Biloba extract and omega 3. After another two weeks, the twitching stopped completely. No more involuntary twitching happened.