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Can't tolerate SSRI's - other suggestions for depression?

Discussion in 'General Treatment' started by pamb, Dec 24, 2011.

  1. pamb

    pamb Senior Member

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    Hi all,

    We have a debate raging up here. My ME (CCC & ICC) hubby is clearly depressed, however since ME arrived about 10 yrs ago every time he tries an SSRI, after about three days his head feels like it is truly going to explode. We've recently moved back to Canada from France and his doc's here, (and son-in-law who is quite wise GP and has seen John at his worst lately and has known him for 30 years) are on a campaign to get him started on an antidepressant. I agree if one would work it would likely help him a bit with his negative and obsessed (with all the pains etc) outlook and perhaps help him find an easier way to come to peace with ME, but I sure don't support trying an SSRI again. Not unless he was hospitalized to try it, and we know hospitals are not good places for people who don't respond in the 'expected' way to medical interventions.

    He is actually doing pretty good, all things considered, and Chinese herbs and acupuncture the last 3 months have been quite helpful with the brain fog and also with energy levels. For this we are both grateful. He is however, perpetually sleep deprived and in pain. Certainly lots of good reasons to feel depressed but the 'black cloud' just does not make any of it easier.

    So my question, has anyone else who is SSRI intolerant tried and succeeded with anything else to help with depression?

    Thanks so much in advance for any stories of success.

    Merry Christmas from the frozen north :Retro smile:

    Pam and John
  2. Sallysblooms

    Sallysblooms P.O.T.S. now SO MUCH BETTER!

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    5htp is really great. If you have a good doctor that knows about supplements, you can get the right dose and brand to work for you. I took it twice a day for a year or so and now just once a day. I have integrative doctors that know the doses of supplements that work for me.
  3. Ocean

    Ocean Senior Member

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    I don't take antidepressants but some people do better I think on the older antidepressants that were out before SSRIs came about. I'm not positive but I think Elavil is one. Maybe those would help? Also what about counseling? Good luck to you guys.
  4. pamb

    pamb Senior Member

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    Thanks for the prompt responses Sallysblooms and Ocean.

    Ocean, Sadly he has tried tricyclics (spelling?) and they just did not do anything one way or another. The docs in France hospitalized him for a week and gave him intravenous amitriptyline, so sure ALL his problems would go away, and same thing, just nothing happened. Other than the inability to get legs to work to walk to bathroom after the first few days.

    Sallysblooms: 5htp sounds interesting. Perhaps we should just hang in there until May when John finally sees a local doc (actually an MD) who takes a natural and digestive system focused approach. He'd be the guy to help us sort 5htp out. John tried it a few years ago, but probably not right dosage and it is pretty powerful stuff to play with. We registered last April to see this doc, and now, 10 years into this thing, a few months does not seem so long to wait. I just need to make sure I get 5htp on the discussion list for the meeting. good thing I can put notes in my digital calendar as my mind's a sieve - but that's just getting older and stress.

    Joyeaux Noel


    Tha
  5. Snow Leopard

    Snow Leopard Senior Member

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    I'm not a fan of tricyclics, due to the side effects like very low blood pressure (I literally can't stand up after having a large dose of amitriptyline). The alternative are http://en.wikipedia.org/wiki/MAOIs
    You do have to go on a low-fermented food diet with the non selective drugs, but if that is a concern, he can try one of the selective MAO-A or MAO-B inhibitors. I've tried Selegiline before (though it's rarely if ever prescribed as an antidepressant) and the effect is kind of like drinking coffee except without the highs and lows you get from coffee (I don't much like coffee, but I didn't mind that drug, so...). Not sure about a mood effect though as I wasn't exactly depressed when I was taking it.
  6. Whit

    Whit Senior Member

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    What is your, or his diet like? Diet can have an impact on mood. List a typical day of food/meals if you feel like it.

    If he has a bad reaction to anti-depressants, I think forcing it in a hospital is a bad idea esp considering how fragile his health is. I had a horrible reaction to Cymbalta and a lot of doctors were very casual about it and wanted me to just keep trying others, which I find questionable.
  7. Sparrow

    Sparrow Senior Member

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    Please don't feel like he needs to take SSRI's if they're awful for him. They may not help. Some of us even get much more dramatically depressed taking them, which many doctors don't keep a good enough eye out for because it's so rare in the general population. Doctors also tend to be focused on raising serotonin levels to try to fix depressive symptoms, but there are some weird cases where that is not at all what's needed. And of course, we're always the weird case. :) If more than one different SSRI has caused problems for him, I would say that his body is telling him clearly that is not good for it. Thankfully, there are other things that might help him.

    I'm one of those who had a HORRIBLE time with antidepressants (including SSRI's), and managed to get my mood boosted regardless. I'm quite cheerful now. :) According to the results of my genetic tests, I'm thinking the problem for me was never low serotonin - and in fact, may have been too much serotonin throwing my balance out of whack. Showed itself in big mood swings. Since many of us seem to react in similar ways to certain things, maybe some of what helped and didn't help me would be useful for your husband to know.

    Things that were horrible for me: Various SSRI's, Effexor, Ritalin, 5HTP (boosts serotonin in a similar way to the SSRI's I think, since my reaction to it was similar if much less intense)

    Things that were ineffective but less severely bad: Wellbutrin

    Things that helped:
    -SAMe (though start very slow and give it time if he feels sick - it's involved in all the methylation cycle stuff as well, so can trigger some side effects at first)
    -inositol (it's a vitamin - I get it in a Douglas Labs product called Brain Calm. I take it twice a day, and it has helped me lots)
    -regularly scheduled meals (I go wacky if my blood sugar has the chance to drop too low. This made a much bigger difference than I would have thought. It's a huge factor)

    I also think the other methylation-related supplements I've been taking (methyl b12, etc.) have helped my mood like crazy as well. ...Which makes sense, since those cycles are involved with the neurotransmitters too, so fixing them up should help that. I would guess that may at least in part be the actual root cause of his depression (in addition to the horrible situation he's currently in). I'm still bed bound right now, but am in a WAY better mood than I was when I was still walking around and able to do way more, so I have to think something else has changed for the better. As a caution, though, more is not necessarily better with any of this stuff - it's all about balance. Too much methyl B12 can make some people moody too. But one tablet a day is great for me.

    Good luck with everything. There is hope. For both of you.
  8. pamb

    pamb Senior Member

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    Gosh, everyone. Thanks so much for lots of good info.

    ahhh, the diet. I know it has too much sugar and carb in it and do my best to influence, without a huge amount of success. When we lived in France I worked from home so could cook for him and make sure he got a somewhat better diet with loads of steamed veg and salads (can take a horse to water but not make him drink) but now I'm gone from home 11-12 hours per day at work (and sleep 8) he is on his own a lot.

    I've got him off wheat at least, and mostly natural sugars from fruits. Not enough veg and not enough good protein. Unfortunately eggs, which are easy, seem to make him really nauseated. He eats lot of WeightWatcher's frozen meals, as they seem best for gluten free and reasonably balanced and does love my homemade beef stew, which I stuff with good veg and freeze in single servings. thickened with arrowroot of course.

    He definitely has regularly scheduled meals and snacks in between a fair bit so I don't think the blood sugar is swinging too much as at least almost all the carbs are fairly complex.

    And you've reminded me, we both need our b12 shots today - a week late. And perhaps we can try the methyl b12 - 1 per day again - while we wait to see the specialist in May.

    Interesting comment re: 5htp and serotonin. It could be indeed that low serotonin is not the issue, and perhaps that is why nothing addressing that helps and usually makes things much worse. we'll try some and see what happens, but I'm definitely going to look up inositol, hopefully they carry it at my favorite i-herb.com, if not I'll order direct.

    thanks again everyone for some great feedback. I'll print this all out and share with John and strategize a bit. Thanks for giving me strength to resist the docs. they just have so little imagination or interest in understanding an ME patient. sigh.
  9. GhostGum

    GhostGum Senior Member

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    Was just reading this recent thread here,

    http://www.longecity.org/forum/topic/51802-gpc-choline-uridine-dha/

    Looks like it could have good potential for anyone with depression, the discussion can be a little heavy but its worth working through, a very interesting combination. By taking 4-6 grams of spirulina apparently I have been getting uridine without even knowing it and have been taking moderate/large doses of omega's 3 for years, might partly explain the huge improvement in my cognition over the past 6 months; might just have to add a little choline.
  10. xrayspex

    xrayspex Senior Member

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    hi i Just wanted to add that i can relate to head exploding from antidepressants, ssris and snris give me horrible headaches, I swear the increase the intracranial pressure in me because sometimes the headaches don't go away for a long time after I try small doses of them. I used to be able to tolerate a minute dose of serzone 14 years ago but no luck in new millenium. I have a thread somewhere here asking similar thing, I found the snris in the pastin small dose helpful for motivation and some pain mngmt and not sure what to use instead but some good suggestions on here, good luck. there is a good test by genelex that tells about your p450 system I paid for it out of pocket and my primary doc wasnt impressed, sigh.
  11. adreno

    adreno 3% neanderthal

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    Tundras of Europa
    Which SSRIs did he try, and at what dose?
  12. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    if he has had bad effects from ssri's and nsri this is common because of our dysfunctional immune and nervous systems. Try more natural alternatives or if meds are needed try using very low doses eg 6mg of zoloft etc this will require cutting pills right down and then crushing them to divide doses further and place in own capsules to get small doses. Also maybe look into ldn as well as it can help mood by increasing endorphins.
  13. Valentijn

    Valentijn Activity Level: 3

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    I suggest getting his neurotransmitters tested first, seeing which ones are high or low, and treating accordingly. SSRI's don't make sense if serotonin levels are already high or normal.
  14. Nielk

    Nielk

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    I have had similar problems with any SSRI that I tried and was pretty depressed at some points of my journey of 10 years.
    The only treatment that ever snapped me out of it is neurofeedback. I tried all kinds of supplements suggested and it didn't budge me. The right practitioner of neurofeedback can affect amazing results. (no side effects)
  15. svetoslav80

    svetoslav80 Senior Member

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    You can try treat him with St John's Wort. Unfortunately it stopped working for me after a week but for you it may be different.
  16. Charles555nc

    Charles555nc Senior Member

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    Sulbutiamine works great for depression for me, its supposed to be anti depressive and also gets thiamin inside the cns.

    b12, b6, methlyfolate, acetyl l carntine and a small number of pushups work for me sometimes.

    I have cfs and I cant tolerate anti depression medication.
  17. GhostGum

    GhostGum Senior Member

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    I just wanted to note that I have already made an order for uridine I am so impressed after finishing reading that whole thread that I linked, even though I am getting some uridine from spirulina I want to try a proper dose sublingually which is what is suggested. Will start a new thread on it when I get the order and report how it goes.

    Charles you already have the ALCAR and b vitamins in this combo covered, maybe worth adding the uridine, omega3's and see how it goes.
  18. pamb

    pamb Senior Member

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    Edmonton, AB, Canada
    Thanks again everyone, for so many interesting suggestions. I'll print this out, research, discuss with John and we'll start experimenting a bit. It is so wonderful to receive so much support when the docs have no clue.

    Happy New Year et Bonne Annee!
    Sallysblooms likes this.
  19. Calathea

    Calathea Darkness therapy

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    You mentioned that he's badly sleep deprived. Darkness therapy has worked wonders for me in terms of sleep, and while it's not directly an antidepressant (although there's been promising research for bipolar disorder), improving his sleep may have a knock-on effect on his mood. Bright light therapy may also be worth a shot. It's best known for treating Seasonal Affective Disorder, but it can also be fairly effective for depression. I've written a blog about my experiences with light therapy and darkness therapy here. Minimal risk of side effects at least (some people get headaches from some forms of bright light therapy, think that's about it), and I reckon that anyone who gets past the stage of being at least mostly housebound with ME isn't getting proper light/dark signals and will be getting negative effects as a result.
  20. Andrew

    Andrew Senior Member

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    People have different reactions to anti-depressant. I take Wellbutrin. It works for me. But not for everyone. What my doctor did is just try one after another until we found one that worked for me.

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