Balance and Antidepressants

[Ernie]

I am in decision mode for my small AN.  Sugery vs. radiation. 

I had a VNG test done about a month age.  It showed that I have lost about 37% of my balance function on the AN side.  But, I think I may have tainted the results.  I take a small dosage of paxil.  I did not realize I was suppossed to discontinue that for 48 hours before my test.  Does anyone know what effect antidepressants my have on the results of a VNG test or balance with an AN?

Usually if I forget to take it for a couple of days I will have some minor balance issues.  I thought it was a withdrawal sympton from Paxil but I am begining to think that the Paxil was actually masking my balance issues that are related to my AN.  I am going to stop taking it for about 2 weeks to see if the symptoms continue.  I am wondering if my balance on the AN side is actually worse than the VNG showed.  That would carry a lot of weight in my decision process.

Thanks
Ernie   

[Jim Scott]

Ernie ~

I can't answer your question about what effect the Paxil may have had on your VNG test.  I believe anti-depressants like Paxil sometimes induce 'dizziness' but a physician could better answer that question for you.  I would suggest that the exact size ('small' can be a relative term with ANs) and, more importantly, the location of your AN are the more relevant issues in deciding on surgery or radiation.   Although balance is usually unaffected by radiation treatment for an acoustic neuroma, if the tumor is too large or too close to the brainstem, surgery may be the more viable option.  These are questions best posed to a doctor, familiar with your medical history and with current MRI images to help him or her make recommendations as to the most efficacious form of treatment. 

Jim 

[Ernie]

Thanks for the reply

My AN was 6mm x 9mm in March.  I have been told by both Dr. Wilkinson and Dr. Schwartz at House that w & w, radio, or micro are all reasonable options given the size and location.

My thinking is that if my balance is ok radio might be the way to go because my understanding is that it basically leaves balance as is.  But, if the balance on the AN side is significantly compromised already micro might be better so that my brain is not getting misinfo.  My concern with radio is that it would allow the misinfo to continue after treatment and possibly get worse if the tumor swells.  If that happened a subsequent micro later would put my facial and hearing nerves at greater risk.  Both Dr. W and Dr. S confirmed to me that micro after radio is much more difficult.

I am definitely having some balance/vertigo issues today.  It is nothing that is extreme and it is not effecting my activities but I do not have these symptoms when I am taking Paxil.  I have not taken any since this past Thursday.  I have always assumed in the past that these are withdrawal symptoms when I forget to take it for a couple of days so it will be interesting to see what happens over the next week or so.

[Vivian B.]

Hi Ernie,

I don't know if this information will help. I don't have any balance issues although I am not always on steady gait if I go up an escalator or turn too quickly, but a balance test two weeks ago showed that I have already lost 49% of my balance nerve. I would have never suspected it. Supposedly, the brain adjusts and the good ear compensates. I would imagine with time, you would get the same results. As far as the anti-depressants, it's possible that because the medication is suppose to numb your feelings to some extent, maybe you don't feel your balance being off as much. I take ativan .5mg for anxiety and I feel when I take it I don't have any AN symptoms as if I didn't have anything wrong at all. I was prescribed Cipralex but only took it for one week. I am wondering if I should try it again. Anyone out there taken Cipralex?

Vivian

[Ernie]

It has almost been one week since I stopped taking Paxil and the vertigo/balance issues continue to get worse.  I was taking a small dosage so I should be through any withdrawal symptoms by now.  I am pretty confident that Paxil was masking the symptoms to a certain extent.  The symptoms are not debilitating but definitely noticeable and now include some nausea.

I happen to meet with the ENT who diagnosed my AN yesterday.  It has been a couple of months since my diagnosis and I wanted to go over some of the info and questions I had from the research I have been doing.  She referred me to a specialist and is not actively involved in my treatment. 

When I mentioned my theory about Paxil masking the balance symptoms she agreed this is a very likely explanation.

It makes me wonder if it might help someone post treatment that is having vert/bal issues.  I AM NOT A DR. SO DON'T JUST RUN WITH MY IDEA.  Antidepr. have different effects on each of us but I wonder if it would be worth a shot, under a doctor's supervision of course. 

I am going to stay of Paxil for a couple more weeks then go back on it to see if there is a difference.

The thing I have been wondering is how should this effect my decision between radio and micro surgery?  If my vert/balance has already been greatly effected it seems like having micro would be the best choice because the nerve would be cut and the misinfo from the AN side would stop.

Anyone have any thoughts about that?

[Jim Scott]

If my vert/balance has already been greatly effected it seems like having micro would be the best choice because the nerve would be cut and the misinfo from the AN side would stop.  Anyone have any thoughts about that?

Yes, I do.  As far as your decision turns on your balance deficits, I agree with your conclusion.

Jim