#565 jodie77

"I've posted on here several times... does anyone have afterimages that lead to ocular migraine?

I have had palinopsia for 4 years now. It started the moment I stopped Zoloft. It has never gone away. I see trails and afterimages in my vision EVERY DAY. With all the research I've done over the past 4 years I've learned that SSRIs (Zoloft, Paxil, Lexapro, etc) can trigger palinopsia [for a review see here]. Apparently a chemical receptor in the brain 5-HT gets inhibited (screwed up) and then causes difficulty in sending the eye a message after it 'sees' something... quite similarly to someone using LSD; the same chemical is affected, therefore causing palinopsia. Some neurologists are keen to this, particularly Dr. Marc J Dinkin out of Boston, MA [see here]. He won't prescribe SSRIs because he knows they can lead to palinopsia.

I now have ocular migraines that occurred out of nowhere. I will be doing nothing in particular then I will get this sparkly, zigzag line in my peripheral vision that leads to blind spots (very scary!!) for about half an hour; then it just goes away. This has happened 6 times over the past 6 months. Had a CT scan of my brain and they found nothing. Also had full dilated eye exam at Wilmer Johns Hopkins (best ER in the world for eye emergency). Doc said my eye was perfectly healthy. Next step is MRI. It's getting ridiculous. No resolution and no one knows why I have palinopsia. I will always believe the Zoloft caused it."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008; additions in square brackets by Klaus Podoll)

"1. Name or screen name: Jodie77

2. Email:

3. Location Baltimore, MD

4. Age: 30

5. Sex: F

6. Nationality and Race: White

7. Do you have classic migraine (migraine with aura) or common migraine (migraine without aura)? When did it begin?

It just started 6 months ago! But I have had palinopisa for 4 years leading up to this (after discontinuing Zoloft).

A week ago I was diagnosed with ocular migraines; I get zigzag, sparkly, half moon shapes in my peripheral vision that lasts 30 minutes and give me temporary blind spots... sometimes a headache follows, sometimes it does not. Have had 6 episodes in 6 months. All new to me, but the palinopsia is not new.

8. What do you take for your classic or common migraine and does it help?

Nothing really, it goes away after 30 minutes...not much pain just a visual aura.

9. Have you been diagnosed with persistent aura (prolonged migraine aura status)?

Ocular migraine.

10. What is your visual problem and how long does it last?

Palinopsia (trails and afterimages) started in 2004 after discontinuation of Zoloft [this attack was typical of two previous nocturnal attacks in 1999, when she saw trails (see below), except that the trails persisted for > 1 week; item B.8 of MAS score]. Gets worse if I drink alcohol or am tired, etc. It has not gone away. Ocular migraine (visual stimuli, zigzag lights, half moon shapes in peripheral vision, blind spots for half an hour) just started 6 months ago.

11. Any other problems that you think might be related?

Palinopsia: Zoloft related.
Ocular migraine: I have no idea.

12. What do you take or do for your vision problem and does it help?

Nothing helps.

13. Have you found a trigger for your vision problem?

For my palinopsia if I am tired or ingest any chemical... if I take Xanax it makes it worse or drink alcohol, etc.

The ocular migraines come out of nowhere.

14. What tests have you had and the results?

CT scan: normal.
Full dilated eye exam: normal.
Blood work: normal.

15. Drug history (pre VS):

Zoloft, Xanax.

16. Drug history (post VS - effect on VS - negative, positive, not at all):

I'm quite certain Zoloft caused this.

17. Do you have a positive family history for migraine? If yes, who is affected?

Nope.

18. Other information you want to provide?"

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008; additions in square brackets by Klaus Podoll)

"When I have ocular migraine it appears that my palinopsia is worsened temporarily... [item B.10 of MAS score] or when I get any headache [item B.9 of MAS score]. It starts during [the aura or headache, respectively]. My ocular migraines last 30 minutes.

Haven't noticed any changes in vision during hormonal cycle... but when I am tired or stressed or hungry or in pain, they get worse.

I took Zoloft for 9 years on and off. Stopped taking it in 2004. Immediately the palinopsia started. I went back on Zoloft to see if they would go away, and it did! As soon as I stopped taking the Zoloft again, trails and afterimages came back.

I was on a steady 50 mg... at one point the doctor had me taking 200 mg!! I was on it for depression... which I don't feel I even needed it or it helped much. I haven't taken an anti depressant since. If I take anti anxiety pill (Xanax or Ativan) my afterimages get worse."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008; additions in square brackets by Klaus Podoll)

"I've always had 'normal' headaches up until 6 months ago. When I say 'normal' I mean just a headache from stress. No vomiting or nausea, no seeing double, no weakness, no blurred vision, no sensitivity to light. Sometimes I would be sensitive to noise but that is normal I'm guessing. I would feel pressure/pain in my head. If I bent over I would feel more pressure. I would take Excedrin Migraine and it would go away. I went immediately to ER once and they did a full neurological exam and CT scan... they said all is normal and to follow-up with primary doc.

I sometimes get 'ice pick' headaches [a manifestation of migraine according to Raskin and Schwartz, 1980] in my right temple. Quick, shooting pain that feels like a stabbing sensation that lasts for a few seconds or minutes.

Six months ago I started seeing sparkly, zig zag lines out of nowhere. They would last for 30 minutes. Sometimes a headache would follow, sometimes it would not. Again, no nausea, vomiting or anything else... just this visual aura.

It doesn't matter what 'type' of headache I have, the palinopsia would always come and get worse for that brief period. Even if it wasn't an ocular migraine."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008; additions in square brackets by Klaus Podoll)

"I think I was 'clinically' depressed from 1996 to 1998. Dealing with a lot back then. So I got put on Zoloft; this is when it [i.e. Zoloft] FIRST came out. To be honest I cannot remember how many times I took it and discontinued it... but my docs had me on it for something ridiculous like a 9 year period. Finally around 2004 I wanted to get off of it permanently. Anytime I tried to stop taking it, I would get zaps [aka shivers; Christmas, 2005] and electrical pains in my head. So weird. So I just sucked it up and quit cold turkey. That is when I got the palinopsia.

The palinopsia scared me so I started taking the Zoloft again for a few weeks to see if that was the cause. Sure enough for those two weeks the palinopsia went away when I started back on the Zoloft. I figured it was a withdrawal symptom and if I stopped taking Zoloft then the palinopsia would eventually go away after a few weeks... well that never happened. I've had it for four years now!"

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008; additions in square brackets by Klaus Podoll)

"Onset of palinopsia: 27 years old.

Onset of ocular migraines? 30 years old."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"Onset of regular headaches was highschool... in my early teens."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"It's hard to explain. It's a white afterimage... no color. It comes immediately after anything passes in my field of vision, whether it is a hand, a car, or whatever. It lasts for a second or two. But I have them 24/7. Anything that moves will have an afterimage (white)."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"Yes, it was around 1996 when I was put on Zoloft. Zoloft is what 'first came out.' I was referring to the Zoloft. The palinopsia occurred shortly after discontinuation in May when I was 27 years old. I will be 31 in two weeks (May 19th)... so I have been suffering wtih palinopsia for 4 years now with no let up or help or understanding or resolution."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"I just remember the week I stopped it I got zaps and palinopsia. I went back on for maybe 25 mg for a week and they went away. I stopped taking it again and the palinopsia came back permanently, the zaps eventually went away after two weeks."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"In 1999 I had two brief episodic periods of palinopsia that went away. Both occurred in the middle of the night. I was under extreme stress, not sleeping well, and was on Zoloft. I saw my dog moving on my bed and his body left and after image... I then moved my hand in front of my face and saw 'trails.' They went away in the morning; I attributed it to being tired. Didn't have another episode until 2004 when I discontinued Zoloft. I was on 50 mg and actually tried weening myself off to 25 mg, then eventually stopped altogether; didn't give myself a lot of time. Palinopsia started and I was thinking to myself, 'Hey I remember this... that one time back in '99.' I figured it was attributed to the Zoloft and that it would eventually go away.

I had moderate depression in anxiety back in the late 90's...was not sleeping or eating well."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 6, 2008)

"After stopping Zoloft for 2 weeks straight I had persistent palinopsia. I went back on Zoloft (25-50 mg) to see if palinopsia would go away. After being on Zoloft for about a week or so, the palinopsia went away as I suspected.

I then discontinued Zoloft again and the palinopsia came back indefinitely. It was four years ago so it's hard for me to remember all the particulars. It was abrupt discontinuation and the palinopsia came back immediately and has lasted ever since. Four years this May to be exact."

(Jodie77 [subject #565], Email to Klaus Podoll, May 7, 2008)

"The two nocturnal attacks occurred after I was asleep and woke up around 2 a.m. Both times they went away after falling back asleep and re awakening.

The persistent palinopsia occurred in the [middle of the] day time while at work after Zoloft discontinuation. I have yet to have relief from 'trails' in my vision, every day, all day, for 4 years.

When I walk from a bright room into a dark room or vice versa it doesn't typically affect my after images. I do however have disturbing 'trails' in the dark. They are typically worse in the early morning hours after waking. Sometimes the trails/palinopsia is better than other days, but there hasn't been one day where I have had full relief since discontinuing Zoloft.

As far as an illustration I am a poor artist but what I see during an ocular migraine is exactly what you have on your 'symptoms' page at the top. That is exactly what I see: a white, zigzag light that leaves a blind spot in its path, and it's particularly hard to read letters because they are blurred out. For instance, I only saw half of my dog's face during an ocular migraine attack. The visual aura is very scary... think I'm going blind, but after 30 minutes it slowly moves out of my field of vision; just vanishes."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 7, 2008)

"As far as the way it looks....I can only explain it by it being this white, zigzag, flashing light, half moon shape that moves to my peripheral vision, leaves a blind spot... lasts for 30 minutes."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Palinopsia and Ocular Migraine, May 7, 2008)

"I found this image of an ocular migraine on a website. This is exactly what I see. It is a sped up version of how it starts and then progresses. I first see a sparkle in the center of my vision... it then gets much larger, takes the shape of a zigzag, shimmering light, (pretty large) moves to my peripheral vision for 30 minutes; as I've indicated before it leaves a blind spot."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Ksomething....here is my picture of Ocular Migraine you requested!!, May 9, 2008)

"Depression because of visual problems?? Does anyone else feel or get depressed because of their visual problems, snow, aura, static, palinopsia, etc?? Like I've mentioned before, I've had persistent palinopsia for four years now and while some days are better than others it is taking a toll on me emotionally. I feel depressed and unmotivated. Kind of like, 'Why did this happen to me if it is so rare?' Now I have ocular migraines on top of it... like I'm going blind for 30 minute intervals. It's just draining. How does everyone cope? I feel sad."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 10, 2008)

"I'm seeing a therapist for depression. I believe mine is situational/circumstantial. I have a really good life but OBSESS over diseases and think I'm having anything from an aneurysm to mitral valve prolapse, to strokes. I research everything and feel I have every fatal disease and symptom. It's ridiculous because I'm an otherwise healthy, 31 (next week) year old. Good genetics in terms of health/heart, etc. I am just a nutcase lately with worry. This pretty much started last month when my girlfriend suddenly died of a heart attack."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 9, 2008)

"My sleep has actually been OK (knock on wood); if anything I sleep too much. Appetite is only compromised when I have severe anxiety, otherwise it has been healthy. No weight loss."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 9, 2008)

"You have no idea how much I relate to this... especially saying after you would wallow in it and not get out of bed. Me too! I had the paramedics come to my house twice in one week for fear of heart attack and stroke. My blood pressure was 170/120 because of panic!!! It's typically 105/65. Then I went to the ER for head CT scan thinking I had brain tumor. Most recently at the doctor's for fear of kidney failure because I urinated too many times in an hour. I become obsessed and very psychosomatic and convinced to the point of believing I have a few weeks to live. What in the hell is wrong with me??? It's driving me insane."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 9, 2008)

In addition to a mild depressive episode with lowered mood and loss of interest, Jodie77 developed an anxiety disorder with a variety of fears and recurring panic attacks that began a month ago after the triggering event of her girlfriend's sudden death from heart attack. According to Jodie77's description, her fears comprised different kinds of fears such as fears associated with perception disturbances and physical symptoms, anxious thoughts, anxieties, which may be associated with panic attacks, and hypochondric fears, such as worrying about somatic functions, or pathological fears of having a certain illness. According to ICD-10, a diagnosis of panic disorder can be made. Panic disorder is a serious health problem but can be successfully treated. The current treatment is a combination of cognitive-behavioral therapy and medication.

"I think I've taken every benzodiazepine (anti anxiety meds) except for maybe Valium.

Klonopin is great... I took it for several years; I think the dosage was .5 mg. But I never used it daily, only when necessary. I took the dissolvable pills. I'd put the little yellow sucker in my mouth and it would instantly dissolve and immediately go into bloodstream --- relaxed me instantly, was great for taking right before bed to get some good rest.

Xanax I have been on and off for many years as well (between .25 and .5 mg) Again, never used it daily, only when I had intense anxiety. This drug is the bomb..ha! It is highly addictive like all benzos but it made me feel 'heavy' not sleepy.

Ativan which I am currently on. Like this one too. I have been taking it regularly for over a month. I take 1 mg per day. I believe this is the most addictive of the benzos and the hardest to quit. I haven't had problems yet. It's very potent I feel. Really calming.

I have to admit, every single benzo that I used made my palinopsia (trails, after-images) worse temporarily, until the drug was out of my system."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - AnXiEtY meds!, May 9, 2008)

"In 1998 [actually October 1987, see below] I was hospitalized for severe dehydration, sleep disturbances and major panic disorder (attacks occurring frequently and without warning especially if I traveled far from home) after my brother died. I lost 15 lbs. I've never touched an illegal substance (besides marijuana in highschool -- used maybe 3 times); when I was taken to the ER the doctors suspected I was under the influence of crack/cocaine due to hives, pacing the floors, racing heart and vomiting. They ordered blood tests, all came back negative. They called in a psychiatrist from Shepperd Pratt and I was diagnosed with 'acute anxiety.' They sent me home with a few pills of Xanax and I started seeing a counselor. I recovered for a few years. I was then back in the hospital during the summer of 2000 for another bout of psychosomatic illness after the breakup with a boyfriend. The physicians at Johns Hopkins thought I had MS because I had tingling in my head, stiff neck, difficulty walking, severely dehydrated, swaying, feelings of my back being 'wet' (possible nerve disruption), and clenching hands into fists and tightly crossing fingers. I didn't sleep for many nights and started hallucinating... [By hallucinations I meant being exhausted from not sleeping...and maybe seeing lights/trails...from sleep deprivation; Email to Klaus Podoll, May 11, 2008] I believe this may have been around the time the palinopsia first occurred twice in the middle of the night (I was on Zoloft) but it went away. They ordered an MRI (came back normal), blood work (normal), CT (normal), and Spinal Tap (could not successfully finish Lumbar Puncture because it wouldn't go through my vertebrae). Neurologist couldn't find anything wrong after full exam. They said, 'It must be anxiety.' I went home with a box full of oxycontin... I have NO idea why they prescribed me that! I got better after a few months. I saw a specialist; it was post traumatic stress syndrome with severe anxiety and sleep disturbances as a result of my break up. The symptoms went away after a few months."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 10, 2008; additions in square brackets by Klaus Podoll)

"October of 1997 (sorry, not 1998) was when I reacted to the death of my brother, but he died in July 1997; 3 month delayed reaction. Yes, the death of my brother triggered some major anxiety and depression. In 2000 my body was acting as if it had MS (multiple sclerosis). I didn't even know what the symptoms were at the time, but the physicians suspected it so I had an MRI done; all came back normal. PTSD was suggested because they felt I was traumatized by the break up of my boyfriend at that time. Don't know if I agree with that one. Probably more along the lines of separation anxiety."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 10, 2008)

"Yes, that is what I think...that I have some deadly illness; I'm such a freaking worry wart."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 11, 2008)

"I believe it was around 1998 [that I was first prescribed benzodiazepines], but cannot be exact. There have been years where I have not taken them at all. Very intermittent. I've been on them more frequently lately because the death of my friend."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 11, 2008)

Concerning the two attacks of seeing trails during night, "I can't be exact. I believe they may have both occurred in 1999."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Depression because of visual problems??, May 11, 2008)

"This is so enlightening and interesting. All the years I had no idea that my symptoms could have been a potential migraine; I would have never guessed. If not, is it 'normal' to develop ocular migraines at the age of 30??"

(Jodie77 [subject #565], Emaiil to Klaus Podoll, May 11, 2008)

"I had a battery of tests run today for my palinopsia and ocular migraines. My eyes still hurt from all the poking and prodding! Anyway, my eyes are perfectly healthy (just as we assumed) and they can't see to find a cause. I told him about my experience with Zoloft and he told me to go back on it!! What? Who suggests to a patient to go back on a medication that caused them visual disturbances? He thinks that will 'cure' it. He said, 'I don't know what I can do for you. Palinopsia is unusual, exceptionally rare. No one knows what causes it.' Then he just looked at me with this blank expression.

I asked if I should at least get an MRI and he said no, not for palinopsia. He told me at least 5 times to go back on Zoloft. What kind of therapy is that? That is what gave me palinopsia to begin with. I wasn't taken seriously at all today."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Ksomething I visited my Neuro-Opthalmologist today, May 20, 2008)

"I wouldn't waste my time or money with seeing a neuro-opthalmologist. All the tests they run typically have to do with the function of the eye....and we all know our problem is "brain" related. As far as I know and have read in past postings they can't do anything for our symptoms...which is fine I guess; I'm learning to live with them. But it's annoying to not have a definitive diagnosis or resolution. Even the doctors don't understand/know what causes these visual phenomena. It's just strange because you want closure you know."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Ksomething I visited my Neuro-Opthalmologist today, May 20, 2008)

"I know I should get an MRI but I had a CT scan a few months ago and it came back perfectly normal. To be honest I think I'm just going to let it go... I'm going to move on with my life and stop trying to find a 'cure' or cause, because I know that Zoloft caused this. Besides, I've seen several doctors all of whom don't have a clue as to where to begin with my symptoms. On my way to the beach to enjoy my life."

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Ksomething I visited my Neuro-Opthalmologist today, May 22, 2008)

"I understand the rational thing to do is to continue to seek help so that I can get a definitive diagnosis but I have been doing that for four years now with no resolution. I'm getting tired. I'm also numb to hearing the same thing from every doctor, 'Your symptoms are so rare and very unusual. How do you spell palinopsia?' I've actually had an opthalmologist at an eye emergency hospital ask me how to spell palinopsia! So far I have seen an ophthalmologist, a neuro-ophthalmologist, my PCP, a nurse practitioner, a psychologist and psychiatrist and back to a neurologist for full exam and CT scan. And why am I the one educating these doctors?"

(Jodie77 [subject #565], Yuku forum Visual snow or static - General discussion - Ksomething I visited my Neuro-Opthalmologist today, May 22, 2008)

References

Christmas MB. 'Brain shivers': from chat room to clinic. Psychiatric Bulletin 2005; 29: 219-221. [PDF]
Raskin NH, Schwartz RK. Icepick-like pain. Neurology 1980; 30: 203-205.

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