AD's PLEASE HELP - anyone who's taken SSRI's or tricyclics....

[kizzie]

Sorry its me again.

After being awake since 4am and getting in a complete state DH took me to drs this mornign.

(4 yrs on seroxat for anxiety based PND. 2 yrs trying to get off after feeling fine. Eventually switched to prozac. Off prozac 6 weeks.)

Things have really gone downhill since taking St Johns Wort. Feeling very desperate.

Dr has told me to reduce SJW but has also said that I need to go back on medication.

She said to forget about withdrawal and that I need to accept that my brain chemistry has changed since i had children (I never had any episodes of depression before then).

Deep down I still feel that the withdrawal is responsible for this despair but im too exhausted to fight anymore.

I cant look after my children. DH is doing everything.

I dont care if it IS withdrawal - I cant go on like this.

Im sorry if this sounds desperate-thats how I feel.

The dr has said I can either take a tricyclic (like dothiepin) or a different SSRI (cipramil or lustral.)

DH is being brilliant with practical things but is not much good at the emotional support - hes had enough of it all. I dont blame him. And my mother just thinks I should pull myself together.
She cant understand how I could change from the independent, bright lively person I was to this.

My BF has just had a baby so cant burden her with it all.

I feel so alone with it all.

Id really appreciate any advice.

I was so determined to beat it this time.
Kizziex

Kizzie - am just about to feed ds. will post again later. sorry you are feeling so low.

cant help
am sure someone will

If it gets worse - ringthe samaritans fast

Hi Kizzie, (long, sorry)
I was diagnosed with PND after the birth of my second child. I think that in all honesty I had it after number 1 too but my determination to pretend that I was coping made me too embarrassed to get help. Admitting that things weren't working was the best thing that I ever did. I've been taking Zoloft since April 2003 and I feel like a normal human being again having normal reactions to situations. I've never felt worried about taking medication for the PND because I was barely functioning as a mother and wife before seeking help and almost as soon as I did I felt so much better about everything.

I had a long chat at the time with one of my friends who is a pharmacist about these new generation treatments for depression. She thinks they are great. They treat the cause of depression by altering the chemistry in your brain, retraining it if you like to respond appropriately to life. Unlike older treatments which masked depression and numbed you, drugs like Zoloft and Prozac don't "make" you happy, sad or indifferent. They let you get out of the rut caused by funny brain chemistry and let you feel happy and sad. She also pointed out that, probably as a throwback to the old tranquiliser phase, people are terrified of addiction and withdrawal to these things. Apparently it is impossible to be physically addicited to these things and, although coming off these drugs has to be managed, if you are really better, it shouldn't be an issue. Unfortunately, lots - if not most - people try to come off the drugs too soon - you need at least 12 months. Many relapse, it is really common.

My theory is that if Zoloft is letting me live the kind of life I want - being an involved mum that isn't too tired to even put on a load of washing and that quite fancies the idea of having sex with hubby, who the hell cares what I'm taking and for how long. I prefer the mum and wife and ME that I am on Zoloft to the crying wreck I was beforehand.

Don't feel bad about being advised to take medication again. If you need it, do it and don't beat yourself up about it. That's the worst thing I found about PND, how it makes you feel so guilty and inadequate. Let people help you. Take care of yourself. Let us know how you go, OK?

great post fabarooney

Hi again Kizzie (yes it takes this long to feed ds(!).

I know it is so tough - but atm you just need to do whatever it takes to make you feel better, even if that means taking meds. Once you feel better, maybe if you look at counselling or cognitive therapy, and careful withdrawal from meds. I know it must feel so unfair that your problems are from withdrawal from Seroxat - Seroxat has had bad effects on a lot of people - apparently it has a very short half-life so goes out of your system very quickly which is part of the reason why it is so difficult to withdraw from. But other SSRIs are different - they have a longer half-life so come out of your system less quickly. I have never taken any tricyclics - but understand that they are likely to have slightly worse side effects and dope you up more than SSRIs. Zoloft (that fabarooney mentioned) is the same as Lustral. I have taken Lustral several years ago for six months and found it pretty good - only side effect I remember was getting dopey when they doubled my dose, and when my dose was decreased feeling loads better again. Hopefully you will feel better once you get the SJW out of your system - the worst side effects I ever had from ADs were from SJW. Also bear in mind that they say for ADs like Prozac that after a few days you may feel a temporary increase in anxiety etc, but that this will go away quickly, and then the drugs will start to kick in - maybe this is what you are experiencing with the SJW. FWIW I believe that if you are feeling low enough to be using SJW, it is better to go to docs than to try to self-medication.

Remember - you have recovered from PND before and you will do again. In a few months time you will feel loads better - it won't happen overnight, and you will barely notice at first, but you will feel better.

Anytime you want to chat, feel free to contact me via contact another talker

kizzie, I take Citalopram (the old version of Cipramil) and it's been fab. I feel like "me" again, if that makes any sense and it's given me the chance to work on the things which were making me depressed. It wouldn't be a huge leap to say it's been a lifesaver for me.

SJW is an SSRI, albeit a very weak one. I decided that I needed to be under a doctor's care for the depression and the drugs, as he could monitor my progress, change the dosages and generally keep an eye on me.

It took about 3 days for the side effects to wear off (a spacey feeling- not unpleasant, but weird) and the drug kicked in almost immediately (although I'm sure some of that immediacy was psychological).

Kizzie, forgot to mention this on last, rambling post (sorry)! One of the best self-help things for clinical depression, once you are feeling up to it, is excercise. Doesn't have to be anything strenuous (trust me!) but even a 30 minute walk releases loads of endorphines and natural feel-good chemicals in the brain that really help give you a lift. One of the worst things about my depression was that I felt as though I had enough energy to get out of bed, even though I didn't want to in the end, and that was about it. It really starts to be a vicious cycle. Once I'd been on the Zoloft / Lustral (thanks for the info mummytosteven) for a few weeks and really started to feel a difference, I took up cycling on the advice of a GP friend who'd also had PND. I find it really helpful and it gives me a real boost. Hang on in there.

kizzie, if I were you I'd stick with the SSRI type drugs, especially if they've helped you in the past. I had a bad reaction to Lustral, very bad nausea and vomiting within days of starting them, so my GP at the time put me on tricyclics. Although I didn't have the violent gastric reactions that I had to the SSRI's, the overall effects were much harder to live with. I was light-headed, sleepy, drugged feeling, terribly constipated and it went on and on, I mean it didn't let up. Most people don't manage to be on tricyclics much beyond 3 months because of the awful side effects. They are also very addictive and have heavy withdrawal symptoms and do worse things to your body's organs if you take them for a long time. In the end I took a different SSRI, started it very slowly in small doses and rode over the side effects. I took it for about 3 years until I got pregnant with dd and thought it was the best thing I ever did. I firmly believe that if you have depression you need to treat it just like you would any other illness. It's awful. I feel for you very much.

Thankyou so much everyone for replying. im going to show them to DH.

At the moment Im still in touch with an SSRI addiction charity which has helped me get off the seroxat - but obviously they are anti SSRI so the viewpoint from them is very biased.

The seroxat actually worked ok for me - the problems only started when i tried to get off itafter 2 years. I had been feeling 100% back to normal for months but the withdrawal was much worse than the original symptoms and I started to get bad side effects even when i upped the dose again. (muumytosteven - it IS the half life that they think causes the problem.)

I was originally put on prozac but that made my anxiety much much worse - this reduced a bit however when the dose was halved to 10mg and in many ways I wish i had stayed on it because then i wouldnt have gone through the seroxat withdrawal.

Anyway am reducing the SJW over next few days because at least then I can tell what is 'me' rather than side effects of SJW. Im hoping that after taking it for only about 10 days it shouldnt be a problem to stop.

I have so many things to look forward to and this is just such a waste of a good life - so although im terrified of taking medication again if necessary thats what I'll do.

Thankyou again everyone!
Kizziex

Kizzie I am so sorry to hear this. You are amazing to even consider coming off the ad's, must take so much strength. I am not going to comment on whether you should go back on medication - I think that is something that only you will know, and you will do what is best for you and your family whatever path you choose.

Only thing I want to say is, it must be a very important issue for you - to have the strength to make that decision and to take these steps, is there anyone else you can talk this through with? Are you or have you ever had any counselling for your anxiety/pnd? It just seems that the roots are still there, maybe I am wrong and it is just chemical imbalance, but could it be worth going back to the time things first started for you and looking really deeply into what was/has/is making you feel down and anxious?
A counsellor could help you with this. Keep talking, loads of love to you, xxxxx.

Kizzie,
I agree with Midden. I was on Seroxat for a couple of years-it helped me through a difficult time of serious (physical) illness, but I suffered terrible withdrawal sypmtoms and it took me months to wean myself off.
I went back to my GP at one point as I felt I needed to go back on, although very reluctant to do so.
She referred me for counselling instead, and it did seem to help-and I did not go back on the Seroxat either.
From what I understand, though Seroxat is far worse than any of the other anti-depressants in terms of withdrawal-so if you need to consider
taking something, bear this in mind.
Hope things get better for you.

Hi Kizzie,
Just wanted to tell you I have taken both SSRIs and tricyclics (back in the days that SSRIs didn't exist, I've been fighting depression on and off for a very long time now), and there is no comparison. Tricyclics make you very dopey, tired, they dry up your mouth, eyes and other secretions and make you constipated. I just couldn't live with them once I knew there was something else available.

I'm another one who takes Lustral and its great. I loved fabarooneys first post about why to take ADs, it totally sums up what I think. I also suffer from kidney stones and it would never cross my mind not to take my painkillers when the pain hits, so why should I not take my ADs? I need them, my stupid brain doesn't work properly, so what if it needs a little help from some chemicals, hey, there are people out there who take worse every weekend!

It is awful to feel like you are a total burden to everyine and if this is how you are feeling (and from your post it sounds like youare pretty desperate) then youhave to do what it takes to get through it.

I'd also like to recommend some counselling or therapy (I've had CBT and gained great benefits from it). Earlier this year I was seriously ill with PND and took an overdose. When I saw the psychiatrist he asked me to try 3 weeks (6 sessions) of counselling with him before we thought about changing my medication and I can;t beleive what a difference it made to me. It made all the difference in the world, I was functional again. Havr you been referred to a psychiatrist? I would have thought that with your history it would be better to be looked after by someone with a little more experience than your GP (I love GPs, my dh is one, but they have to know their limitations, and refer on toa specialist when neccesary. This might be worthwhile for you),

HTH

Thanks for all the new replies. I really appreciate all your views.

Susan - I'm so glad you're feeling better. I was wondering how you were doing a couple of weeks ago.
I've started some CBT sessions and I am seeing a psychiatrist as well as my GP.

Unfortunately the one I was seeing left and they didnt replace him for ages but am due to see the new one in 2 weeks.

I still see my PND counsellor privately (she does general counselling too) and she is fantastic. her view is that most of this is caused by the withdrawal because she saw me when I was totally well from the PND and she doesnt think I have underlying 'issues'. However her view - and I'm starting to thinkt the same - is that in some ways it irrelevant. If I feel this bad then I should take something because life isnt meant to be like this.

Am still not sure im doing the right thing stopping the SJW - when havent given it enough time to work. Felt v low this morning even before taking it so cant blame it all on the SJW. Also panic and anxiety v bad last night after reducing the dose down. I know my system is hyper sensitive to everything and every change right now.

But overall I think it probably is best to stop it because as one of you said if I really do need medication then self prescibing SJW is not a good idea - and also its probably best to see how I am without anything to give the dr a better idea of where I am.

Anyway - sorry for another long note.
Kizziex

Kizzie - Much sympathy. {hugs{}}
I've taken some great advice from this thread too. Do what you need to do to live your life without this depression... Fabarooney's post really summed it all up.

Just checking in, Kizzie. Hope you're doing OK today.

also wondering how you're doing today, Kizzie

Hello - thanks for thinking of me.
Unfortunately things havent improved.
I have now stopped the SJW because at least then Im starting from square one.

The anxiety today is unbearable. None of the techniques Ive learned over the years are having any effect.

I will probably get to speak to the psychiatrist before the end of the week. The message Ive had is that i will prob need to take a tricyclic because of all the difficulties Ive had with SSRI's. So if anyone has anything at all positive to say about them that would eb really helpful.

Although Im still sure that the problems are down to withdrawal Im am going to have to accept that this is now irrelevant - I just need to get back on an even keel.

Thankyou everyone for all your support
Kizziex

kizzie - though tricyclics have bad side effects they are as effective as ssris for treating depression. they tend not to be used cos of the side effects and as they are more toxic in overdose than ssris. but they work, as well or even better than ssris.
my experience of them is with imipramine and dothiepin. i would take imipramine again if i had to but dothiepin turned me into a zombie, it is very sedating.
sorry for typing am feeding baby!
hope you can see the psych this week to get something sorted out. all the best.

Old tricyclic antidepressants can cause sedation, which I think is the side effect that most people have concerns about. There are newer "non sedating" tricyclic antidepressants - which cause less sedation (I don't think there are any that can be guaranteed not to cause any sedation in everybody) but everybody reacts differently and in some people some sedation is not a bad thing if it will help you sleep. Also some people find that tricyclics work better for them than SSRIs. There are also other antidepressants which are neither tricyclic or SSRI which may be an option. If you are concerned re. particular side effects make sure you tell the prescriber (GP or pysciatrist)- they should be able to choose one that is less likely to cause that particular problem IYSWIM.

Hi Kizzie. Not had any personal info with tricyclics, but have read that imipramine is the least likely to cause side-effects/sedation. (source being easyweb.easynet.co.uk/simplepsych/tricyclics.html). If you talk to the psych about it, they should hopefully give you a good idea about it.

Try and pin the psych down to your withdrawal probs - i.e. make it clear that you feel the short half life of Seroxat caused the probs, and ask him about people's experience of withdrawing from tricyclics - you may also want to see if your SSRI addiction charity can advise on tricyclics.
Hope you feel better soon
XX
Laura

Thankyou for that info - will look up the link.

I spoke to the SSRI charity last night. They are fairly anti all the medication but in fact were much less anti the tricyclics than i expected.

I have to bear in mind though that they have an anti SSRI agenda so their view will be biased.

Its all so confusing.

Thanks again
Kizziex

Kizzie - I'm on Cipralex (newer version of Cipramil). It is effective for anxiety attacks as well as 'just' depression. I found that I was less paranoid about things within a week of starting to take it. I was originally on 10mg, but it became less effective after a few months, so I increased to 20mg per day. That seemed to do the trick. Unfortunately, I tried to reduce my dose to 10mg again about two months ago, and I ended up in despair after a month. I went back up to 20mg a day, and have not been able to perk up again since.

kizzie, just a thought, have you looked into the very newest antidepressants which are neither SSRI nor tricyclics? One of them is called 'mirtazipine' and is meant to be especially good for anxiety and has very very few side effects apart from some sedation in the first few days.

Hi Kizzie, Hope you are feeling a bit better today. Just thought I'd chip in on the SSRI charity thing - it's really easy to be anti-medication if you don't need it! Depression is such a life-altering, disabling condition when left untreated.

Chat it all through with your GP and the psychiatrist, they know you and are in the best position to give you advice that's appropriate for you and your circumstances. Tell them your concerns about the medication, they may be able to chat through your fears and help you find something that's more suitable than the things you've tried before. How about showing them some of the posts on this thread with advice on the newer meds that other people have found helpful?

Is there anything else apart from the side-effect / withrawal issue that makes you reluctant to take medication? When I consider coming off the meds, I have to confess that the main reason is that I'd like to not be someone that has a mental illness. People are lots more understanding than they were, particularly about PND, but I still think there is a bit of a stigma. Then, I remember how much better I feel now and feel daft for thinking that way! Is anything like this bothering you?
Big hugs to you, take care.

Fabaroony, you talk a lot of sense!

Kizzie, I have recently changed from Cipramil (40mg) to Venlafaxine (new drug, don't know much about it), and in the three weeks it took to 'kick in' I was going berserk! It's so scary when you go back to those feelings but you have to just ride the storm until you come out into the sunshine again.

I too would love to be someone who doesn't have a mental illness and can work again and I hope one day I can but for the moment I'm 'in recovery'.

Hugs to all of you in the same boat (mumsnutters?).