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Talk to me about SSRI medication, please

(108 Posts)
Cairngorms Thu 21-Mar-13 13:40:31

I've had phases of depression for many years, but not ever taken medication. Over the past year, I've had major anxiety too associated with some very major life changes we are dealing with.

In the summer, I so desperate that I was prescribed an SSRI which I took. The side effects when I started were horrible, really horrible, my husband disapproved in general, and longer term it reduced my desire to have sex, which caused issues with my husband. I am not brilliant about remembering to take it, and during the autumn something came up where DH disagreed with me doing something because I was on medication, so I stopped taking it altogether.

I am now really unstable again - anxious, depressed, unhappy. I would like to try taking the SSRI again, BUT
- I am worried about the short-term side effects;
- I am worried about reduced libido again;
- I am worried about facing the GP who told me NOT to stop taking it.

How do I face the GP, face the DH's disapproval, find an SSRI with reduced starting side effects and also without the reduced libido effect?

Please help! I am finding this overwhelmingly hard.

fluffyanimal Thu 21-Mar-13 13:49:05

There should be no stigma attached to taking medication for depression/anxiety. These can be caused by chemical imbalances in the brain and do not need to be caused by bad things in one's life. The tendency can be to think that one should just be able to cope or to pull oneself together, but it is not as simple as that.

So if you need medication, you need medication. It can be trial and error finding the right one as we are all different. You need to go back to the GP and explain the side effects were too bad for you.

But why does your DH disapprove? Does he think you should just be able to pull yourself together? And what might come up that being on ADs would prevent you from doing, and even if they did, why is it for DH to disagree with you - isn't it up to you to make that call? And finally, surely any self-respecting DH would prefer a well partner with a reduced libido to an unwell partner with a heightened libido? hmm and even angry about your DH I'm afraid.

orangeandlemons Thu 21-Mar-13 13:52:58

Try one of the older type ad's. they don't have the same start up effects as Ssri's, and don't affect your libido as much

monkeysbignuts Thu 21-Mar-13 13:56:44

I am taking fluoxetine at the minute for postnatal depression and I have been fine starting on it. Which one were you on?
I was initially put on citalopram which made me feel dreadful.

I would go back to your gp and explain everything and maybe try something else?
Good luck

Cairngorms Thu 21-Mar-13 13:59:51

OP here: I was prescribed SERTRALINE.

Cairngorms Thu 21-Mar-13 14:03:24

orangeandlemons aren't they more addictive?

I was hoping to get something by Easter, so I can go through the two weeks start-up during the school holidays.

orangeandlemons Thu 21-Mar-13 14:05:32

No, that's tranquillisers.

I mean the tricyclics antidepressants, ones like imipramine and clomiprimene

Cairngorms Thu 21-Mar-13 14:40:29

fluffyanimal I am coming to terms with agreeing with you about the straightforward need for medication and that there should be no stigma. I'll try to explain to the GP, but I'm worried about seeing them for this again, having quit medication the last time.

DH is really unsupportive about it. He thinks I just shouldn't be stressed / depressed / anxious and that's the end of it, problem sorted. I wanted to apply for a tempting PT job, and he was throwing reasons at me that I shouldn't take the job - I'm not mentally well enough, as evidenced by the ads, amongst other things - and I was trying to remove the reasons as I really wanted to go for the job. Regular sex is very important to him. I may agree with you, but that's another issue.

Cairngorms Thu 21-Mar-13 14:57:58

Just tried to make a GP appointment, but none available till after Easter. The receptionist suggested I made an on-the-day appointment tomorrow (or other day I'm available). I could restart the tablets I was prescribed before - I have a packet in a drawer, and that was my initial plan, but I wonder whether I can find something I'll feel less ill on.

Why are SSRIs prescribed rather than tricyclics? What are their advantages?

orangeandlemons Thu 21-Mar-13 15:44:19

Tricyclics were the first ads before Ssri's. Ssri's are meant to have less side effects, however tricyclics don't have the horrid start up effects that Ssri's have.

I struggled rally badly with start up effects on Ssri's, so have taken the other sort.

monkeysbignuts Thu 21-Mar-13 17:48:54

Every med is different and will effect you differently. I would ring on the day and speak to your gp.
Citalopram is an ssri and so is prozac, I was ill on citalopram and fine on prozac x

NanaNina Thu 21-Mar-13 17:58:06

Cairngorms I can only endorse everything that Fluffyanimal says. I'm sorry to be direct but I suspect your (D)H is the bigger problem and your relationship with him could be the origins of your depression and anxiety. Sorry but I just felt so angry with him, because I know from personal experience the torment of dep/anx and the stigma that still surrounds mental illness, and to have an unsupportive partner is just so awful. You have mentioned that you may agree FA but that's another issue and maybe that issue needs sorting sooner rather than later.

I think you should make an appt with a GP asap (I assume the one you saw last time and maybe want to see again) is the one who can't fit you in till after Easter. Don't be worried about stopping the ADs - lots of people do this, and GPs are well used to that happening, but will underline the importance of staying on the meds and having reviews from time to time with the GP to talk about side effects, benefits etc.

I really don't think you should start taking the ones you have left over. ADs are not like paracetomol that you can take at any time and get relief. Brain chemistry is very complicated. Did the Sertraline give you any relief from the symptoms when you took it in the summer. I know you had bad side effects but did they diminish and did you begin to feel better? How long did you take them for? This is important to think about (putting aside your DH's disapproval). This is important to think about because IF they relieved the symptoms it does mean that they were an AD that suited you, even though problems with libido. YOu say regular sex is important to your husband but your mental health is important to you (sorry I am just so mad at him) and it's people like him that perpetuate the stigma around mental illness, to say nothing of the effect it is having on you.

It IS trial and error with ADs I'm afraid - Sertraline is an SSRI as is citalopram, and there are others that people have mentioned. There are also older meds known as tryclics (I am on one - imipramine - and there is another amatriptyline) The NICE guidelines are for GPs to prescribe citalopram (or another SSRI) like sertraline, as they are safer in overdose, as the older ones are not. I suppose research must have shown that the SSRIs were more effective than the tryclics. The frustration is finding the one to suit you as they react differently on different people.

SO please make an appt asap and tell the GP what has happened and make a list of your symptoms - as an aide memoir for you, or to just hand over to him/her if you feel unable to talk, as sometimes we just burst into tears once we are in the surgery.

The trouble is just at the time when you need some emotional strength to cope with your DH and GP visit, it is the time when you are emotionally very vulnerable, but you are important and you need to get better, especially as you have children. There are many books about depression as I'm sure you know - Amazon is crammed with them. Why not get one and put it in front of your DH - and let him see how outdated his notions of mental illness are. Better still get him to go the GP with you, though I doubt he would do that.

Sending warm wishes to you and please remember that you will get better -but only if you get the help you need and deserve from the NHS.

Lucyellensmum95 Thu 21-Mar-13 18:09:10

marks place to add my twopenneth later and also learn from others' imput. Flufflydressingown talks lots of sense.

Cairngorms Thu 21-Mar-13 18:18:47

"Did the Sertraline give you any relief from the symptoms when you took it in the summer. I know you had bad side effects but did they diminish and did you begin to feel better? How long did you take them for?"

I think Sertraline gave some relief from depression symptoms (symptoms certainly lessened, but there was other stuff going on that lessened a bit too and I suspect the symptoms would have lessened a bit anyway). The first two weeks were SO AWFUL, completely debilitating and leaving me unable to function at all, I utterly dread going through that again. Ongoing side effects were minimal, I think the no-sex thing was the most significant. I started and remained on the lowest dose.

Jollyb Thu 21-Mar-13 18:26:28

Hi I would definitely go back to your GP to discuss your concerns. It might be worth a trial of another SSRI. I'm currently on citalopram which has knocked my libido (but am also 21 weeks pregnant which probably in't helping). I have taken a different SSRI in the past, paroxetine, which didn't have this effect.

As others have said there are alternatives ie tricyclics. They are not more addictive as such but can be more dangerous if overdosed.

orangeandlemons Thu 21-Mar-13 18:35:23

Also, you can start at a low dose and buildup if the side effects were bad last time

TheSilveryPussycat Thu 21-Mar-13 18:44:54

On paraxatine which I find v v good, w few side effects (slight nausea and stomach feeling odd) which soon passed. Am on maintenance dose of 20mg which I possibly don't need now.

Libido went in 2003, mostly. I thought it was menopause to start off with. No, twas the fact I no longer respected my H it seems. Depression lifted when I filed for divorce in 2011. Took a while for full recovery following Ex's final departure. By this time was old gimmer and assumed libido gone for good. (But no, recently reawakened by someone I do respect)

Lucyellensmum95 Thu 21-Mar-13 18:45:12

The last time i took citalopram i was fine, limited side effects and yes there was a lack of labido but still had sex and when i had an orgasm (which is rare) it was out of this world and i would pass out blush It seemed to work straight away, but after a few months i needed to up my dose - from 20mg to 40mg.

This time around i have been really in a bad way and just started citalopram with diazepam. I have been suicidal this week and had to be seen by the emergency psych team. My DP, like yours, very anti - but he knows i am very poorly just now - I have decided to continue with the citalopram. The shrink did say they can take a bit longer to work the second time.

There are others - i think citalopram is the first port of call - i know it worked for me last time. DP isn't happy really as he said i wasn't "me" last time.

I am in a waiting list for counselling - you need to back the meds up with something, find the source of your issues.

Yes there might not be anything trigering just now but you need to find a way to cope - cbt might help you, it didn't work for me but i know that it works for many folk.

I think its very hard for partners, they often don't understand, which is understandable, i dont get it myself.

Tricyclics are not the drug of choice as they are more addictive than SSRIs

Lucyellensmum95 Thu 21-Mar-13 18:49:37

I really don't think you should re-start the medication without consulting your GP first - try an on the day appointment tomorrow, if you can't get one, ask for a phone consultation.

i understand your DPs reticence, but i don't like what you write about him one minute saying "why are you depressed, you have no reason to be depressed" (you don't NEED one) to using it as a reaon for you not to take on part-time work. Actually taking the job could be just what you need - it will help your self esteem and give you something to focus on. The psych that i saw yesterday agreed with me that i need to be working. He NEEDs to be more supportive.

Cairngorms Thu 21-Mar-13 18:58:42

OP here: I am really appreciating the input here, thank you. I am trying to answer a few things that come up. With respect to the job, it would have been good but there would have been some challenges too (we have A LOT of domestic / family complexity at present), I got an interview but not the job (there were people with more relevant experience and I couldn't do the hours they wanted). I don't need to work, financially, and there are very few jobs that I actually WANT to do but if I see another I'll apply again. I'm currently volunteering to get more experience.

wrt CBT, I had 7 sessions which is all I can access through the NHS. We focused on self-esteem and it was useful.

dragonflymama Thu 21-Mar-13 19:00:12

Sorry to hear you're not well. I am also disappointed to read your dp isn't being v supportive....that is surely exacberating the problem. I would suggest a gp appt ASAP to find the right meds, stick with them for as long as prescribed (coming off early is counter-productive) and seek counselling for both of you so your dp can start to understand more about mental health issues. You may also find ways to work through "dark days" together through CBT. Good luck!

Cairngorms Fri 22-Mar-13 08:18:50

I have an appointment today with the GP I saw before. I hope he isn't too cross with me. I've told DH who is .... resigned and not disagreeable, but not as supportive as I would hope. I am worried about side effects, the GP, my DH and that I won't stick with taking the medication long term again.
Wish me luck!
Someone suggested I wrote notes. I may try that.

Cairngorms Fri 22-Mar-13 12:30:42

I now have 30 days worth of fluoxtine (Prozac), and a suggestion from the doc that I don't tell DH. I'm looking at the box and wondering whether I dare take one and how ill it will make me.

NanaNina Fri 22-Mar-13 14:23:20

Hmm I'm not sure I agree with the GPs suggestion that you don't tell DH, unless he is very certain that if DH knows and is unsupportive you won't take them. Your GP will know you much more than we do of course, so that may be his reasoning. If it is then so be it and only you can know whether that is good advice or not. However you did say that DH is "resigned and not disagreeable" and he know you have a GP appt, so it seems likely he will ask yu what happened and if you say you weren't put on meds, he might take that to mean that you really do just have to "pull yourself together" and reinforce his belief that depression is not a serious illness which needs treating with meds.

However after all that ruminating you absolutely must start taking the meds. Have you been started on a low dose of Prozac and when are you meant to be taking them, as you posted at 12.30 trying to decide if you should take them?

IF you are meant to be taking them x 3 per day and you should be taking one at 12.30 then you must take it. I know how scarey it is and the one trouble with this MH thread is you do hear people talking of horrendous side effects and you might not have any of them, but even if you do it isn't going to be anything that you can't cope with - yu aren't going to be turned into a zombie or anything. I know you had really bad side effects on sertraline but you did also say that you thought they might have been lessening your symptoms (although some life stresses lessened too)

OK you might get bad side effects but they will almost certainly dimish (you said the awful side effects lasted 2 weeks) and that's not long. The side effects of the new meds might be better or worse for side effects but you need to give them chance to work, because as you probably know you feel the side effects before the benefit and some ADs raise your anxiety until they have "kicked-in" - did you tell the GP about the sex problem. If so he may be taking this into account with the meds he has prescribed.

HOWEVER you DH's "need" for regular sex is just going to have to go on the back burner until you are well again. Look CG you have taken a very important step in seeing the GP, so learn by the mistakes of the past and don't give up on them. Have you got another appt for GP to review the meds and whether they are helping.

OK call me bossy but please please take the meds NOW and post and tell us that yu have. I am around all day as am retired so willing to hold your hand so to speak.

monkeysbignuts Fri 22-Mar-13 14:43:04

I am absolutely fine on prozac. I really hope it works for you too x

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