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What is least damaging med for depression, panic

Discussion in 'General ME/CFS Discussion' started by perrier, May 11, 2016.

  1. perrier

    perrier Senior Member

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    My daughter has severe bouts, rather frequent, of some sort of crises. A form of panic perhaps.
    Perhaps depression. All due to the consequences of this diabolical illnes, which has robbed her of normal life and left her bed bound, and housebound.

    She's on a bit of Klonopin, alas.

    What med could help with the other symptoms and not be too damaging?

    Thanks folks.
     
  2. Living Dead

    Living Dead Senior Member

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    Lamotrigine and vitamin D.
     
  3. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    Without knowing what her diagnosis is, (and you don't sound sure yourself), there's no way to know what medication could help her. You don't say how old she is. If she's younger than 20, I wouldn't trust anyone other than a psychiatrist (not a GP!) to prescribe meds.
    Lamotrigine made me wet the bed (not once, but twice!) when I was falling asleep. No previous history of incontinence or night-time bed-wetting ever. YMMV!
     
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  4. halcyon

    halcyon Senior Member

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    Does she have POTS/NMH and/or other symptoms of dysautonomia? I believe it's pretty common for folks with dysautonomia to experience panic attacks or something like them. I've experienced this myself on numerous occasions.
     
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  5. valentinelynx

    valentinelynx Senior Member

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    On the natural side, I find L-theanine helpful for when my anxiety spikes.

    I also (like your daughter) use a small dose of clonazepam daily, which helps tremendously to prevent more severe anxiety attacks.

    I used to take Effexor (venlafaxine) for chronic anxiety. It was very helpful - made it possible for me to face the public again. The first couple of days on it were rough - seemed to make anxiety worse. The downside of this medication is that,it can be very difficult to withdraw from.

    I find there is a balance between my fatigue and anxiety. If the fatigue drops, the anxiety increases and vice versa. I hate anxiety so much, I'd rather be crushed by fatigue!
     
  6. justy

    justy Donate Advocate Demonstrate

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    If she has ME, EDS or MCAS then please be very careful with SSRI antidepressants, a subset of us have a lot of problems with these. Personally I had SEVERE akasthesia that lasted over two years after just two doses of Citalopram - it took 5 years for the generalised anxiety from it to subside. I am amazed I survived. As you can imagine this didn't help my ME any.
     
  7. perrier

    perrier Senior Member

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    Thanks everyone for the advice. She has ME, dysautonomia too. Pots. Seems pretty classic ME. There may be some Lyme. Tests are positive borderline.

    I know that antidepressants can be damaging in ME. That's why I asked.

    She uses l Theanine and Lactium daily. Not enough, alas. Crying bouts, despair, wailing.

    Not unexpected for a young person with three university degrees, whose hard work and ambitions were cut down overnight by this demon ME.

    But I can see she's unable now to control then attacks, and I'm just wondering what is safe to give.
     
  8. caledonia

    caledonia

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    Having also been through the mill with benzodiazepams and an SSRI, my suggestion would be to not use those until you have explored other things first. I've also experienced the severe akathisia Justy mentioned. It was a horrible experience and I'm not sure how I lived through it either. I'm currently on a 5 year taper off Zoloft and will hopefully be off that for good at the end of 2017.

    In general, it sounds like your daughter could use some counseling to help her deal with her loss of her former active life. I did this the first several years I was sick and it was very helpful.

    Physically speaking, there could be problems with the thyroid and/or adrenals which could cause anxiety/depression. In that case, you would want to treat those. See the Stop the Thyroid Madness website for more info.

    Since she has POTS you would want to make sure that's under control. There are medications to help with a racing heartrate or low blood pressure. Treating the adrenals could also be helpful.

    Other than that, I can suggest consulting with integrativepsychiatry.net. They would likely have you do a neuroadrenal profile, which is a test for neurotransmitters and saliva cortisol for adrenals. Then they can prescribe supplements based on that.

    Another option is working with a methylation doctor. It could be she has some gene mutations such as MTHFR causing problems. Supporting the methylation cycle could help. Many of us on here have this.

    Another option is a William Walsh practitioner such as Dr. Mensah. They specialize in supplementation for mental health also based on methylation, but they come at it from a different angle than regular methylation doctors.

    Beyond that (and this is more of a long term solution), you can check for the presence of mercury or other toxic metals with a hair toxic metals and essential elements test. If these are present you would chelate them out. The only type of chelation I would suggest is Andrew Cutler's frequent dose chelation.

    I have links for methylation doctors and Cutler in my signature link.

    If you do decide to go the psych med route, nowadays you can get gene testing to see which meds are compatible with your body and most likely to be effective before you take them. This should cut down on bad reactions or lengthy time spent trying different medications until you get one that works.

    ps. one other possibility is your daughter could be having rebound (withdrawal effects) from the clonazepam. If she is a fast metabolizer, one dose per day would wear off in 6-8 hours and she could have withdrawal effects after that (usually panic/anxety). If she's a slow metabolizer, even at one dose per day, it could be hanging around in her system too long causing problems (usually things like fatigue and getting worse and worse).
     
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  9. Mary

    Mary Senior Member

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    @perrier - check out this thread: http://forums.phoenixrising.me/inde...nxiety-symptoms-with-three-supplements.18369/

    I had a horrible reaction to SSRIs and think most anxiety etc. can be managed with proper supplements. Caledonia has some very good suggestions and the thread I linked also does. Low omega 3's can cause severe depression and so on.

    Doctors in general seem to know nothing about neurotransmitters and just hand out drugs which generally just mask symptoms and often create worse problems as noted above.

    And counseling can help, though it can take some effort to find someone competent. This is a terribly cruel illness as you know too well and having someone outside the family to talk to, just to vent, could help your daughter.
     
  10. caledonia

    caledonia

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    Good point regarding essential fatty acids. They are essential, but the body doesn't produce them, so they must come from diet or supplements. Modern diets don't supply enough omega 3s.

    If you're deficient, supplementation can help with mood, pain and more. If you do fish oil, be sure to get pharmaceutical grade or molecular distilled, so that it's not contaminated with mercury or PCBs.
     
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  11. Mary

    Mary Senior Member

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    Also if you check out Hip's thread which I linked above, you'll see that flaxseed oil which is high in omega 3's is one of the 3 top supplements he used to get rid of his severe anxiety.
     
  12. halcyon

    halcyon Senior Member

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    Does she take any medication for the POTS?
     
  13. JES

    JES Senior Member

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    Of meds targeted towards depression, one of the least harmful is Moclobemide, which is a reversible MAOI with minimal side effects compared to irreversible MAOI's. But it's not available in US if you live there.
     
  14. barbc56

    barbc56 Senior Member

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    @JES

    I'm intrigued and would like to learn more about this medication, including why it's not approved in the US.. I've never heard of an MAO inhibitor where your diet isn't restricted. But it looks like it's an MAOI which I'm not familiar with nor how it's different. Here is a review of studies on Moclobemide.

    Isn't there another AD that's not available in the US? Maybe this is what I'm thinking of but I don’t think it was an MAOI.

    Thanks.

    http://www.ncbi.nlm.nih.gov/pubmed/12595913

    This is from 2003 but am going to look for some updates. It's been around for a while as I found another study fro 1998.
     
  15. Hip

    Hip Senior Member

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    If it is generalized anxiety disorder (GAD) she if suffering from, rather than panic disorder (PD), then this might help:

    Completely eliminated my severe anxiety symptoms with three supplements!


    Both GAD and PD occur in ME/CFS. The basic difference is that GAD is more continuous anxiety, whereas PD involves acute panic attacks of anxiety that typically last 5 to 30 minutes.
     
  16. markiz2001

    markiz2001

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  17. JES

    JES Senior Member

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    It doesn't restrict the diet, I could eat pretty much anything while I trialed it. Also side effects at least for me where minimal compared to SSRI. Reason it's not approved in US is no other than money, none is willing to finance costs for FDA approval, especially now when the patent has expired. This is sadly the case with many interesting medications...
     
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  18. perrier

    perrier Senior Member

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    This is very interesting for poor old Canada, where generally not too much sophisticated stuff is available. And if there is something, it's in Toronto! Thanks. Lots to read there.
     
  19. perrier

    perrier Senior Member

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    thanks for all the details. Counselling has been and is provided. It doesn't really help a brilliant young person, whose friends have all gone on to become highly accomplisished, one now being proposed to become the youngest dean in his faculty, several medical specialists, etc. While she sits at home with an aging Mum, nursing pain. She has done some research and published articles, but that's not a real life. No relationships, no physical touch, except from family, no outings, no career, no self realization, just house arrest. I guess people deal with things differently. Some accommodate to a situation, others become frustrated and want to end their lives.

    She is on Cortef for the adrenals, something I I now really regret. But every physician insisted it was safe.16 mg per day. And weaning off is not easy. Various supplements have been included.

    What we need is to find a caring doctor who will say to her: I'll take care of you, and th problems you face. We are Canadians, from Quebec. And I have travelled all over, and somehow I have not been clever enough to find this sort of Doctor.

    If anyone out there knows of a gifted physician, who is really caring, and willing to help with this demon illness, please let me know. Cancer patients are treated with great seriousness, and they are helped. I know this as a family member is now going through this. But walk in with this nightmare illness and you leave with a bag of supplements, which are often of questionable value.

    I really need to find a good doctor soon.
     
  20. xrunner

    xrunner Senior Member

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    it could be the side effects of cortef...
     

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