Post-Medication Dizziness and Neurological Symptoms

Two weeks after discontinuing antihypertensive medication, I feel a heaviness in my head and occasionally experience brief episodes of dizziness?

Hello doctor, on March 30th, my physician prescribed me Forxiga 10mg for weight loss.
On April 5th, I returned to the clinic due to discomfort near my heart and had an ECG, which was normal, but my blood pressure was 155/101.
The doctor asked if I wanted to try a blood pressure medication (Olmetec 20mg).
On the day I took it (at 5 PM), I felt dizzy.
By Thursday morning (April 7th) at 11 AM, I started experiencing numbness in my head, followed by numbness and coldness in my hands and feet, along with dizziness.
A friend called an ambulance, and after examination at the hospital, it was determined to be a side effect.
On Friday (April 8th), I returned to the clinic, and the doctor advised me to stop the medication, with my last dose taken on Thursday at 5 PM.
On Saturday (April 9th), I stopped taking Forxiga, but then I began to experience a heavy dizziness in the back of my head.
On the nights of April 10th and 11th, I had trouble sleeping and felt a pulsing sensation in the back of my head.
By April 12th, I started to sleep better, but in the mornings, I still felt heaviness in the back of my head and occasional dizziness.
The doctor mentioned it could be due to mental stress, and sometimes my scalp feels numb and tight.
Now, I also feel like I have a cold, and every night around 10 PM, I feel fatigued and dizzy.
Even now, I still experience heaviness in the back of my head.
Doctor, could you please advise if this is still a side effect or if I am experiencing neurological weakness? Thank you.

Alvin, 40~49 year old female. Ask Date: 2016/04/21

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it is unclear whether you have a problem with sleep apnea, as obstructive sleep apnea is closely related to obesity.
The complications of sleep apnea primarily affect the cardiovascular system, leading to hypertension, myocardial infarction, and stroke.
It can also impact blood coagulation functions, result in thrombosis, affect cognitive function, alter personality, and cause polyuria.
Daytime sleepiness may occur and can trigger abnormal functioning of the sympathetic and parasympathetic nervous systems.
As for the new generation glucose-lowering medication Forxiga (Dapagliflozin), it works by inhibiting the sodium-glucose co-transporter 2 (SGLT2), blocking glucose reabsorption in the kidneys, which leads to increased glucose excretion in urine and a reduction in plasma glucose levels and body weight.
I recommend that you consult a neurologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, concerned about you.

Reply Date: 2016/04/21

More Info

It sounds like you have been experiencing a range of concerning symptoms following the initiation of medications, specifically Forxiga (dapagliflozin) and Olmetec (olmesartan). Your symptoms, including dizziness, numbness, and a feeling of heaviness in the back of your head, can indeed be distressing and may be related to the medications you were prescribed.

Firstly, Forxiga is primarily used for managing type 2 diabetes and has been associated with weight loss in some patients. Common side effects include urinary tract infections, genital infections, and dehydration, but neurological symptoms like dizziness are less common. On the other hand, Olmetec is an antihypertensive medication used to treat high blood pressure. It can cause side effects such as dizziness, especially when starting the medication or increasing the dose, due to its blood pressure-lowering effects.

The symptoms you described, particularly the dizziness and numbness, could be attributed to a few factors:
1. Medication Side Effects: Both medications can cause dizziness, especially when you first start taking them or if your blood pressure drops too low. If your blood pressure was elevated at the time of your appointment, the introduction of Olmetec could have led to a significant drop in blood pressure, resulting in dizziness and other neurological symptoms.

2. Anxiety and Stress: Your doctor mentioned that your symptoms could be related to mental stress or anxiety. It is not uncommon for anxiety to manifest physically, leading to symptoms like dizziness, numbness, and a feeling of heaviness in the head. The stress of dealing with health issues can exacerbate these feelings.

3. Neurological Concerns: While it is less likely, persistent neurological symptoms should be evaluated further. If your symptoms do not improve or worsen, it would be prudent to consult a neurologist for a thorough evaluation. They may recommend imaging studies or other tests to rule out any underlying neurological conditions.

4. Withdrawal Effects: Since you stopped taking the medications, it is possible that your body is adjusting to the absence of these drugs, which could also contribute to your symptoms.
Given your ongoing symptoms, it is essential to maintain open communication with your healthcare provider. Here are some recommendations:
- Follow-Up Appointments: Schedule a follow-up appointment with your doctor to discuss your symptoms in detail. It may be helpful to keep a diary of your symptoms, noting when they occur and any potential triggers.

- Blood Pressure Monitoring: Regularly monitor your blood pressure at home to see if it remains within a normal range. This can help your doctor assess whether the medications were effective or if adjustments are needed.

- Mental Health Support: If anxiety is a contributing factor, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can be beneficial in managing anxiety and its physical manifestations.

- Lifestyle Modifications: Incorporate stress-reducing activities into your routine, such as yoga, meditation, or gentle exercise, which can help alleviate both physical and mental symptoms.

In conclusion, while your symptoms may be related to medication side effects, anxiety, or withdrawal, it is crucial to seek further evaluation if they persist. Your health and well-being are paramount, and addressing these symptoms with your healthcare provider will help you find the most appropriate path forward.

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