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

[peggy-sue]

It's having ME that got me depressed. Cure me, and my depression will go!
My depression is always reactive - put me in an untenable position, with no way out and I will get depression.
I'm going to have to investigate trazodone...

I do already take high dose fish oils - pharmaceutical grade - but I avoid DHA like the plague. EPA is the right one.
I did, for a couple of months take one with DHA, because I couldn't get hold of my EPA one - and I went right downhill brain-wise. Just a fortnight back on my EPA and I was back to "normal".
Quite enough proof for me that DHA is bad!

 

[jeffrez]

DHA really screwed me up, too. I just stick to EPA now, and whatever DHA might come naturally from fish.

 

[Sparrow]

Just wanted to clarify that I'm not anti-Trazodone. Just that, like all brain-altering medications, different people will react badly to different ones. None of them seem to be one size fits all.

 

[Lala]

Peggy and Jeff, which brand of DHA-free fish oil do you use?

 

[adreno]

Note that EPA lowers cortisol, whereas DHA does not. For depression, EPA seems to be the effective omega. For cognitive function, DHA is very important.

 

[Lala]

Well, with low cortisol and depression at the same time, what should you take? I take fish oil for years, cuz my doctor wants me to do it, but I have never seen any effect.

 

[peggy-sue]

It was on DHA that my cog. function went - it came back with my EPA.
The stuff I use is called Vegepa, it's made by a company called Igennus. There's a lovely lady who runs a private scheme to get it cheaply - and donate to MEResearch at the same time.
Despite its name, the stuff is not vegetatian - the fish oil comes from anchovies.

 

[Lala]

Thanx peggy, how would you evaluate an antidepressive effect? Mild-moderate-strong...?

 

[adreno]

Well, with low cortisol and depression at the same time, what should you take? I take fish oil for years, cuz my doctor wants me to do it, but I have never seen any effect.

Reasonable doses of EPA (~500mg) shouldn't be a problem, even with low cortisol. To treat both depression and low cortisol (usually described as atypical depression), I would try an SSRI, SJW or curcumin.

 

[peggy-sue]

I don't use it for depression, I use it to support and improve my functioning level with ME.
However, I believe Vegepa has come out well in trials for mild depression - it is recommended for it.
I don't think I've ever had mild depression. I get obsessive about the thing that's affecting me, I default to performing stereotypies (wandering around in circles talking to myself), then when anhedonia sets in
(total flatness - wishing to be dead, can't tell the difference between eating chocolate and dog mess) and I know I need serious prescription medication.

This is the Igennus page on EPA and depression - you might find it useful?

http://igennus-hn.com/health-benefi...il-for-depression/vegepa-fish-oil-depression/

I take 8 capsules of vegepa every day.

 

[wastwater]

5-htp vitamin d

 

[Lala]

Thanks peggy..

I am unable to tolerate SSRI and I have tried almost all of them, nor I have seen any effect from curcumin. I did not try SJW yet. So that is on my list of future possibilities.

I got some positive effect from combination of lithium orotate and tryptophan, also high dose methylfolate is effective, but due to the headache I had to decrease dose of last one and there was definitely worsening of depression again. Also ATP fuel along with Riboscardio did some work (I suppose effect comes more from ATP fuel).

 

[jeffrez]

Peggy and Jeff, which brand of DHA-free fish oil do you use?

I used some Nordic Naturals formulation. Like Peggy, the DHA really impaired my cognition, but thankfully it corrected when the DHA wore off. Perhaps there was an issue of needing a proper balance with EPA/DHA. I don't remember the brand, but I've never taken DHA since. I rely on eating sardines a couple times a week to keep my omegas up.

 

[SOC]

Hum. I just get the Kaiser generic (as with all my meds) and it's always been the same for me. Perhaps you fell victim to a bad batch.

Very likely. Or some "innocuous" ingredient in the Pliva brand that's not in the Apotex brand seriously disagrees with me. I stick to the Apotex brand now and sleep beautifully.

 

[pamb]

Thanks all, for the conversation. We've had some luck with really dark room for sleeping and used a SAD light in winter, now in summer he sits out in the morning sun for 30 min. or so most days and it really helps.
Most interesting update is our year long wait to see Dr. Stephen Genuis finally ended and we saw him on May 30. He is an MD with a very strong environmental medicine focus. We had a short delay in getting started as I pondered the $7000 cost and poverty in my retirement, but ya gotta do what you can. He's done a ton of tests and I meet with him this Tuesday for a review and may start treatment soon. He said he has found some nasty pesticides and heavy metals, plus, no surprise here, a completely screwed up digestive system - and he figures the pesticide could definitely be negatively impacting mood. Will try to remember to update in a month or so when we are deeper in to it.

 

[PhoenixDown]

An older tetracyclic called trazodone can sometimes work when you can't tolerate TCAs or SSRIs. Not only does trazodone not have the sexual and other side effects that the others have, but it can have a positive effect on sexual function and can also promote stage 4 sleep, very important in ME/CFS.

Having an involuntary boner at 3am when you need to urinate, is hardly a positive effect. I suggest you re-read the side effects list of Trazadone.

 

[peggy-sue]

I did read up on trazodone, and decided against it. It does have the neuterising effects.

http://www.rxlist.com/oleptro-drug/side-effects-interactions.htm

 

[PhoenixDown]

Pam, what exactly do you mean by depression? What exactly are you trying to treat? Sadness? Fatigue? Motivational problems?

 

[heapsreal]

acetyl l tyrosine(amino acid) can help increase noradrenaline which can help improve mood as well as energy. I think for many if they look into adrenal fatigue and treat hormonal problems then this can help greatly with depression as well. I would recommend getting a cortisol/dhea/pregenolone test done first and then maybe after treating this for awhile get sex hormones tested too.

 

[jeffrez]

I did read up on trazodone, and decided against it. It does have the neuterising effects.

http://www.rxlist.com/oleptro-drug/side-effects-interactions.htm

That concern is greatly overstated, especially in men. Because of the unique mechanism of action of trazodone, including inhibition/antagonism of alpha2 receptors, it's extremely unlikely for one to get the sexual dysfunction side effects with it that the SSRIs and TCAs frequently produce. In fact, it's often used on its own as an off-label treatment for sexual dysfunction, and sometimes even in conjunction with SSRIs to treat those particular side effects caused by those newer ADs.