Antidepressants anyone?

[dwfreck]

Hello everyone,

My family doctor prescribed anti-depressants for me about two years ago, 'cause I was depressed (early mid-life crisis brought on by an early surgical warning from my cardiologist). I feel like I've turned the corner, and have asked the doctor if I can work my way off of them. Does anyone else have experience with these kinds of meds? I'd be especially interested in their role in coping with pre- and post-surgery and their potential interaction with any of the cardiological meds.

 

[Nancy]

A large percentage of heart surgery patients are on antidepressants. It helps tremendously.

 

[hensylee]

Towards the end of my dear Joe's life the doctor gave me Paxil. I took it and it helped wonderfully, but one day I decided to just give it up so I would leave off a pill, then take one two days in a row, leave off another, take two days, leave off another, take one day, leave off the next-----make your own schedule to see how it works for you. You probably don't have to ask your doctor's permission to give them up unless there's a strong reason to be on them. Just be very careful coming off them - or your dr can advise you. I had no trouble getting off.

 

[medtronic of borg]

food for thought

food for thought

I strongly suggest to you to remain on them. Depression is normal after heart surgery. If your off them your asking for trouble. Stay on them for now. Try considering weaning when your body is back to a more "normal" state. Like a year after the surgery.

Med

 

[Kevin M]

I agree with Med on this one.

I've been on antidepressents for a couple of years. I tried to wean off, but immediately had a relapse into depression.

Some of it depends on what antidepressent you are on. They aren't all from the same 'family', you need to watch your drug interactions. I'm on Celexa and do not notice any side effects except for nausea in the mornings if I do not eat.

When it is time to get off them, it's best to do so slowly, like Ann suggested.

If it really bugs you and you think you can cope, then why not try to go off them? You can always go back on again. If your depression was a side-effect of getting the bad news, then once you deal with that, maybe you will be fine. If it's like mine and you have chemical imbalances in your brain, then you probably should not mess around until the traumatic parts of the upcoming experience are all done.
Kev

 

[dwfreck]

Thanks everyone.

When I said I wanted to work my way off of them, I was thinking long-term, like in the next six to twelve months.

I started on Effexor. That ruined my sleeping patterns, so we changed to Celexa. That suppressed my sexual response, made it harder to get out of bed in the morning and left me sleepy all day, so we changed to Lexapro (a re-patent of Celexa). That had the same side effects as Celexa (not surprisingly), just not as intensely, so we're now changing to Welbutrin.

I've been on the Welbutrin just under a week, so the changes aren't all evident yet, but I'm a lot less drowsy, can concentrate better at work, and may be getting back to my normal sexual response. If the Welbutrin works out, I'd like to stay on it as long as it doesn't interfere with my surgery. Although considering my ranting in another thread about my first meeting with my surgeon, perhaps I should keep a closer watch on my emotions.

 

[Kevin M]

Your comments about Celexa explain a few things for me.
I am sleepy all the time and seem to have... ahem... a similar concern regarding libido.
Kev

 

[Nancy]

For those on Effexor-- Joe was on that for a very short time. His blood-pressure rose to 200 over whatever. It was very, very dangerous for him, and it could have triggered a cascade of serious medical conditions that eventually landed him in the hospital for a month.

In addition to that it was a son-of-a-gun to get off of, even with the taper down schedule, it was horrible, horrible, horrible!

So monitor your BP at home if possible.

 

[dwfreck]

Kevin,

Celexa is one of a family of drugs called Selective Serotonin Reuptake Inhibitors, or SSRIs. If you search the web for the word "Celexa", you'll find several sites that discuss the side effects of SSRIs that some people experience. Drowsiness and sexual effects are quite common with this family of drugs.

If you'd like to be less drowsy and/or to fix your libido, I suggest talking to the doctor who prescribed the Celexa about an alternative that doesn't have the same side effects. That's what I did, and that's how I ended up trying Lexapro and Welbutrin.

Of course, if you're in the waiting room or only a few weeks post-op, then you may not want to fix your libidio just yet...

 

[dwfreck]

Nancy,

My experience with Effexor was that it made me more tense and anxious; I didn't measure my blood pressure, but I wouldn't be surprised if it was high.

I also noticed that if I missed just one day's dose, I was an emotional wreck. When I "got off" Effexor, I didn't stop Effexor cold turkey, I substituted Celexa for it.

I was so disappointed with Effexor that I've decided to rename it to Ineffexor.

 

[ccrawford]

Dale - When I was first diagnosed, I started using Welbutrin, not as an antidepressant, but as a smoking cessation aid. At the same time, my cardio had prescribed two meds for blood pressure, one for cholesterol, and Coumadin because I had had several TIA's. I also used the patch briefly, and the cessation chewing gum for several weeks. This concoction of drugs really did a number on me and I spent a lot of time in the recliner sick and dizzy. I got through the agony of cessation in a couple of weeks, and then decided to quit Welbutrin. I immediately started to feel better. I attribute the problems to the mix of drugs, not necessarily Welbutrin. Oh, by the way, It helped me lose about twenty pounds too - all in a period of about two months. Note it takes a few weeks before the drug has accumulated in your system and then it will start to work.Hope you have good luck with it. Chris

 

[Mara]

Medtronic is right on the money on this. I agree completely. If you don't like the one you're on switch to something else. I had great success with Celexa pre and post-op.

 

[Jennie]

Hi Dale,

I've been depressed since I was a teenager, but I crashed and burned about a month after my surgery. It was like a massive emotional jet lag. My cardiologist compared it to mourning, that it would take at least a year, your body's in shock from such an invasive procedure. He said 90% of people he sees who've had this sort of surgery come in with depression.

I'm on Celexa. Started on 20mg a day, zonked me out massively. Cut back to 10mg a day, was very tired, spacey, but happy. After a year, I cut back to 10mg every other day, then once every three days, moving toward a total wean. I was doing great by the end of the summer, but then I crashed and burned, sobbed for ten days straight while I ramped up again. Now I'm back on 10mg, every other day. Happy, and not too tired.

I saw my cardio in September and asked, what's the deal, it's been almost a year and a half since my surgery, why am I still an emotional wreck without these drugs? He said, well, what's normal? If we had a couple hundred people your age who had this sort of surgery, maybe we could do a study, but basically, everyone who walks in his door has a different story about this depression stuff. So, maybe it runs in the family? Maybe I'm not totally over the surgery (I also had a wire removal this spring)? Maybe it's just part of the chronic depression that never got dealt with before?

No answers here, sorry Dale! Just my own questions. I guess one thing that I am wondering is, is my "every other day" on Celexa a problem? Meaning, am I hindering its long-term effectiveness or cutting my chances of being able to get off this permanently by taking it every other day instead of every day? Should I ask my doc or pharm about this?

thanks, and best wishes to you....
Jennie

 

[Nancy]

Yes Jennie-

I think you should discuss it with the pharmacist or your doctor. Perhaps this med needs to be an even dosage in your system to be as effective as possible. Is there such a thing as 5 mg per day? Anyways, discuss it and see what they both say. Might do some good to even it out.

Best wishes.

 

[Jennie]

Thanks Nancy,

I will ask them about this. There is no 5mg a day, that I am aware of. The smallest pill, last time I checked, is 20mg, and I am splitting that in half....

Yes'm, will do!!

JEnnie

UPDATE: Me again. Pharm says they do have a 10mg version, so I'll call the cardio on Monday and see what he thinks about re-prescribing. Thanks!!

 

[dwfreck]

Jennie,

As I said earlier, I'm on my fourth AD med and am waiting to see how it works for me. If you're not comfortable with your current state of relative happiness vs. numbness, OR you're not happy with some of the other side effects, then definitely talk to your doctor or pharmacist. We all want to be happy without taking happy pills, but sometimes our body chemistry gets in the way.

I like to think of it this way: it took me several years to get depressed to the point that I asked for medication; it will probably take several years to get back to "normal".

 

[medtronic of borg]

suggestion#2

suggestion#2

Reading between the lines you seem to be going up and down . Go to the hospital and schedule a meeting with the psych department. You may want to bring up the mood swings and the drug Depakote.

Med

 

[dwfreck]

Med 'o Borg,

Thanks for the advice about the psych dept. I've considered seeing a psychologist, and my family has experience with one for other issues. I haven't ruled it out, but at this point, I'm comfortable with where my family doctor and I are going.

The reason for the latest change in meds is not so much that I was up and down as it was that I wasn't anywhere; I didn't get sad or angry or happy or joyfull. I wasn't enjoying the enjoyable things in life. Then there were the side effects: I couldn't focus on anything, especially work; I needed eight or more hours of sleep each night to be able to get out of bed the next morning; and I was overexerting myself (in the cardiac sense) to be satisfied sexually.

 

[Birky]

anti depressants

anti depressants

I have been on Zoloft since 3 mos. after the surgery. I only take 50mg. a day and this keeps things in control for me. Mine wasn't so much depression as it was anxiety. No smoking, new valve and surgery. Combination of all. I am sure I had my days when I was really down and I think this must be normal for all that was done to me. My daughter was on Effexor for her RA and really had a hard time coming off of it. My husband was on it for 2 years and just weaned himself off with no problems that I could see. I plan on staying on this for a while since it seems to be working good.