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What ADs are you on? Need to do some research

41 replies

naswm · 10/10/2006 14:33

I am going to the GP to get some ADs. MY GP is hopeless and I think I am going to have to fight for them. So I want to go armed with aas much information as possible.

I know they all come with some side affects. But are any better than others? In particular I dont want to put on weight, or feel nauseous, or dizzy, or have horrible nightmares, etc etc (not much to ask eh?)

OP posts:
naswm · 10/10/2006 18:36

oo can I come with you zippi?

OP posts:
CaptainCavemansMummy · 10/10/2006 18:42

\linkwww.nice.org.uk/page.aspx?o=cg023\NICE Guidance

Hope that link works!!

The National Institute for Clinical Excellence issue guidance on all manner of things, including depression care.
GPs (and others) can choose not to follow the NICE guidance but must be able to demonstrate a rationale for doing so. hth

I had Prozac but it made me so ill, but that was because it exacerbated my anxiety and panic. Now on Citalopram and (fingers crossed) felt really well for past 6 months or so...

Good luck!

anniediv · 10/10/2006 18:42

naswm don't think about it like that, because every day you will be making a teeny tiny improvement anyway, with or without the ADs. Have you had any counselling at all? How about email support or phone counselling from APNI or somewhere like that? You will start to feel better and get on top of this, keep posting on here too.

CaptainCavemansMummy · 10/10/2006 18:43

ok I don't think I did it right!

Go to www.nice.org.uk and type depression into the search....

I'll keep practising typing links!

CaptainCavemansMummy · 10/10/2006 18:44

\link{http://www.nice.org.uk/page.aspx?o=cg023\NICE guidance

one last try!

CaptainCavemansMummy · 10/10/2006 18:45

NICE

If this doesn't work I will stop trying!

anniediv · 10/10/2006 18:48

well done cavey, 4th time lucky!

CaptainCavemansMummy · 10/10/2006 18:50

(ahem) It often helps to read how to do it properly before attempting to post links.
Note to self....

northerndad2006 · 10/10/2006 19:08

Hi. This isn't an expert opinion, but I hope it helps.

In general terms, drug treatments are:
SSRIs - Selective Seretonin Reuptake Inhibitors - increase the brain concentration of seretonin (a neurotransmitter). These include citalopram, escitalopram, fluoxetine, paroxetine (various posters have mentioned tradenames e.g. prozac = fluoxetine). They have various side-effects but what made one person feel really ill may be fine for you - or vice versa.
SNRA - Selective Noradrenaline Reuptake inhibitors i.e. Venlafaxine - this works on noradrenaline (neurotransmitter) as well as seretonin. Generally second line as a bit more effective than SSRIs.
TCAs - tricyclic antidepressants e.g. amitryptilline, clomipramine. Older drugs - still effective, but maybe more troublesome side effects - dry mouth, constipation, sleepiness (of course if you took two people, one might be happy with amitryptilline and not get on at all with sertraline). Part of the reason they are less used is that they are much more dangerous in overdose than SSRIs.
Some others, e.g. mirtazipine, lithium - if you're getting to this stage, then a psychiatrist would be very helpful - GPs certainly wouldn't be starting Lithium.

Non-drug treatments:
Cognitive Therapy: useful treatment if it is available where you live. Nothing like Freudian lying on a sofa talking about your parents. Actually very common sense e.g. challenging persistent negative thought patterns
e.g. all or nothing thinking: 'My daugher fell off the bed and banged her head whilst I was distracted. I'm a terrible mother.' Are mothers either all good or all bad? No-one's perfect but your daughter is loved, well fed, safe and is usually closely watched.'
thought-reading: they think I'm stupid' How can you tell what other people are thinking?
And so on. Provides you with a tool kit for dealing with life's stresses.

Counselling - some people find it helpful; I'm not up to date with the evidence, but I don't think the evidence base is all that good.

Various other psychological treatments.

If you'd like more information on a particular drug / side effects, I'll happily post it.

Having said all that, the drugs do all have side-effects, and most drugs can have serious ones sometimes. You said that you don't fit the typical pattern for depression. I'm not at all questioning that you are having difficulties, but it's important to make sure you are actually depressed before starting these treatments. If you're not confident about your GP's view that ADs aren't for you, then can you see another one? It's possible that he is right, but if that is so, it will be important for you to be confident of this, so you can try a different strategy. Sorry if this last bit sounds vague and even patronising; I'm not trying to be.

lulumama · 10/10/2006 19:20

Wow Notherndad - what a great summary !

Naswm - when i was prescribed the right medication, it took a few DAYS to work - in conjunction with intensive therapy - don;t be put off

even if it takes 12 months to return you to 'normality' - then that is a tiny sacrifice in terms of time , to live the rest of your life in a positive and fulfilling way.....

snuffy143 · 10/10/2006 19:30

Have been taking Venlafaxine since 2002. I take a 75mg dose at bedtime, it is a slow release capsule. I still see a psychiatrist (echo the advice about them knowing FAR more about drugs than a GP - my GP was very honest about it) and every spring we talk about reducing the dose...I am too scared, tbh. I have a normal life and have just returned to FT teaching after 8 years in the wilderness. I have had no side effects and would recommend trying really hard to get sorted...i know it is hard when you have all the symptoms of PND. All the best.

northerndad2006 · 10/10/2006 19:33

In addittion to NICE guideance, these should be useful - includes stuff for patients
Royal College of Psychiatrists stuff on depression

naswm · 10/10/2006 22:58

Gosh what a lot of info. Northerndad that is V helpful. I cant open the links now (DH around) but I will tomorrow and read up as much as I can. Re your last paragraph btw - I dont mind you saying that at all. I can see how I may have come across as someone who is unsure etc. But I definitely am depressed - and have been for as many years of my life as I can remember (earliest recollection is primary school). The reason my GP was reluctant to give ADs in the past was for 2 reasons - 1) I was anti (I wasnt ready to accpt it, and wanted to try other things first, eg natural and counselling - private though because he woldnt refer me... and 2) becuase, in his words, I just have to accept the stresses and strains in my life and adjust to lilving with them. But I have come a long way since then, and know now that the thigns I have been trying are not enough, and that I cannot continue to sink lower and lower and lower. It just simply isnt safe. Thanks so much everyone. Nx

OP posts:
zippitippitoes · 13/10/2006 10:21

how are you..have you seen the gp yet?

kelseybaby1 · 14/10/2006 20:20

HI
all side effects should disappear within two weeks if your body can tolerate whatever drug. I have been on citalapram for anxiety and panic disorder for 10 years and have found it to be really good.
If you suffer a genuine chemical imbalance then ad's are indicated but if your depression is situational then the problem needs to be addressed and possibly other methods rather than ad's are more appropriate.
good luck
lol
k

naswm · 23/10/2006 21:12

sorry I've been avoiding mn and msn for a while (I have to do that from time to time when I feel particularly bad). I DID go to the GP. It was a complete disaster. He reluctantly prescribed some ADs - some very unsual thing, which on reading the leaflet I cannot take, due to contraindications which he should be aware of. Anyway, I have not taken them. But I have made some big steps in that I have started to be honest with people about how I have been feeeling, eg homeopath (which has helped me a great deal) and have told dh too. Thanks for all your advice before. As I have always said, I have never ruled ADs out - but for various reasons, it seems I am not to meant to be taking them atm! Nx

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