Short serotonin gene and ssri startup activation/anxiety :
I have EXTREME reactions to starting ssri’s. The first one I tried zoloft gave me akathisia, extreme restlenesss, constant anxiety etc. I’m not bipolar and have no family history of Bipolar. I do have the short serotonin transporter gene, which is linked to this effect. I also have other genes linked to negative experiences when starting ssri’s, that have to do with glutamate. This is not definitive but it is interesting. This same gene is also linked to emotional reactivity and sensitivity to anxiety and depression under negative events.
“The short (S) variant of the serotonin transporter gene (often called 5-HTTLPR) has been linked in some studies to greater sensitivity to SSRIs during startup, especially increased anxiety, agitation, emotional intensity, and “activation” symptoms. The theory is that people with the short allele tend to have lower serotonin transporter expression, so when an SSRI suddenly blocks serotonin reuptake, the nervous system may experience a more abrupt serotonin shift, temporarily overstimulating stress and emotional circuits before adaptation occurs. This has been proposed as one reason some people experience startup anxiety, panic, vivid dreams, dysphoria, emotional worsening, or feeling “amped up” early in SSRI treatment.”