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-   -   Anti-Depressants and PD (https://www.neurotalk.org/parkinson-s-disease/8656-anti-depressants-pd.html)

GregD 12-13-2006 12:16 AM

Thanks reverett123 (Rick),
Just when I thought I finally had discovered what depression is, you come along and confuse the he:: out of me.

Earlier this year, I stopped taking Paxil. For me it was a breeze. I understand some people have trouble when getting off of PAXIL. Ask Eve I think it was about that. Anyhow, I went six months without any type of antidepressant in my system. Towards the end of this 6 months I was fully understanding why I had been on an antidepressant. I noticed myself all of a sudden thinking gloomy "depressive thoughts". And for no reason, find myself crying over the drop of a pin. This happens and includes big strong men and big strong women, as well as those who went through their previous life with the will of George Patton, or the daily tension of a seasoned army doctor, who has done the most incredible things and never flinched, being reduced to a crying, blithering, non-functional self.(ol cs, I hope you don't mind if I used your discription of depression. It such an accurate discription)

My doctor had me start on Wellbutrin. Well, the depressive thoughts have gone away, I stopped having thoes emotional moments because I just dropped a pin. Once again I'm able to face my day without dread or horror. One setback to Wellbutrin seems to be weight gain. I've put on almost 20 lbs. in the past three months. I know, I know, those darn parkies. They're always complaining about somthing.:D :D :D

GregD

K Hamilton 12-13-2006 11:40 PM

Ol' CS:
Your description is a good one. Mine came along with anxiety, too; the only description I can give it is as "my own private vision of Hell" - nothing but hopelessness and terror as far as the eye can see. I never want to go there again. I'm taking way too many pills, but the ones for depression and the ones for PD have got to stay.

To get back to rd42's original question, I understand that there are some PWP's who have had no depression at all, and more that experienced it only the first few months after diagnosis. More than 50%, though, do experience some depression of more than a few weeks duration.

rd42 12-14-2006 01:27 PM

It's tough for me to call it depression, it would be better described by moments of shear terror like the world is caving in with a daily undercurrent of anxiety. I'm so hypersensitive to medication, I'm a little hesitant to try anything.

Thanks for all the great responses.

Robert

:D

wendy s 12-14-2006 05:38 PM

Robert, I know exactly what you're talking about when you describe a daily undercurrent of anxiety. It drives me crazy, I really don't think PD would be affecting me that badly if it weren't for the anxiety. It's less than it was three years ago, but it still makes everything twice as difficult as it should be. I'm beginning to think that I don't want to have to put up with it, but am even more anxious about starting another medication. How's that for being caught between a rock and a hard place?

Has anyone used medication just for anxiety? I looked it up on the Ask The Doctor site, and there were various ones suggested, but I got the impression it's a hard thing to improve. There must be a reason that not everyone with PD is anxious, and I'd sure like to know what the difference is between the anxious and not anxious ones!

Evon 12-14-2006 08:52 PM

Greg, Kris, Robert, Wendy I know exactly what you are talking about. That awful anxious feelinng and a feeling of doom and gloom. Mine started well befor the dxs of P.D. I tried Paxil and it worked but I did have problems getting off of it, the effexor seems to work for me without a lot of weight gain. Although I am only taking a small amount, I'd like to keep it that way. I really thought I could be without an antidepressant but it was only a couple of months after stopping the Paxil that I felt like I was falling into the big, black hole again. There is no way I want to feel anxious and sad all the time so I choose to take the antipressants, after all its only one more pill, and it makes a huge difference.

ol'cs 12-15-2006 02:37 AM

Anxiety and depression...
 
Are supposed to be a result of overstimulation of the varioius "5HT receptor" cells (anxiety), and a dearth of intracellular 5HT transmissions (depression). With the case where anxiety, paranoia, compulsive behaviors, feeling squeezed to the breaking point, etc.
Often PD'ism , with all of it's molecular arrows only intensifies these personality traits, in SOME of us. Like all symptoms of the Parkinson's disease, some will be displayed resulting in the exclamation that what is happening to you is "non-intuitive" for PD.
Let me just add that there are very effective methods in action today, that can describe any aspect of the human condition. Parkinsons researchers are , today, right now, trying to figure what PD is all about and how to fix the damn thing. Even if it's only a 50% fix, that at least would put a whole lot of us in a happier place.
Only you can save yourself :) cs

reverett123 12-15-2006 09:30 AM

neither black nor white
 
http://www.washingtonpost.com/wp-dyn...121300452.html

Evon 12-15-2006 09:41 AM

Compulsive behaviour
 
cs You brought up compulsive behaviour along with anxiety. I do have compulsive behaviour but was blaming it on the Requip that I am taking. I have been concerned about increasing the agonist in fear that the OCB may get worse. On the other hand if I increase the Effexor it may get better. Oh what a game we play looking for the balance that we need to live a somewhat normal life.

ZucchiniFlower 12-15-2006 09:11 PM

Seems effexor also doesn't affect blood pressure:

Pharmacotherapy

Pharmacotherapy of depression in PD is generally effective. Tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and newer antidepressants such as venlafaxine (effexor) and bupropion all have a role in the treatment of PD depression. Patients who are already hypotensive may do better with venlafaxine 37.5 mg b.i.d. or venlafaxine XR 75 mg o.d. as it spares blood pressure. Venlafaxine may also have a more rapid onset of effect. Normotensive depressed patients who have difficulty sleeping and/or maintaining weight can be helped with a tricyclic antidepressant such as nortriptyline 50 mg q.h.s. Nortriptyline taken between 6 p.m. and 8 p.m., combined with a glass of juice upon awakening but before getting out of bed, will help overcome early-morning dry mouth, hypotension, and grogginess.[7]

SSRIs are useful but may be stimulating rather than sedating. Some patients, especially the elderly, may experience agitation (authors' observation). SSRIs can also cause anorexia, which may be undesirable in an underweight patient or in one who already has gastric side effects from antiparkinson drugs. SSRIs are not contraindicated because of occasional case reports of worsening of parkinsonism. Nonetheless, patients' mobility should be monitored for this possible adverse effect.[13,14]

From:

Depression, anxiety, and psychosis in Parkinson's disease

https://www.bcma.org/public/bc_medic...Depression.asp

Effexor also helps with pain!


Another antidepressant that appears to have an analgesic effect without anticholinergic activity is venlafaxine (Effexor), and this should be considered as an alternative if the tricyclics are contraindicated or are poorly tolerated. The selective serotonin reuptake inhibitor antidepressants appear to have less analgesic effect than the tricyclics

http://www.geriatrictimes.com/g001029.html

Sorry, this article says it can raise blood pressure!

"Venlafaxine is a ‘mixed’ antidepressant agent. It prevents the uptake of both norepinepherine and 5-hydroxytryptophan. The initial starting dose is 37.5 mg daily. It should be titrated slowly up to a maximum of 150 mg daily in the elderly patient. It is also available in an extended release preparation. Venlafaxine should be used with caution in hypertensive patients since it can raise blood pressure."

http://www.sciencedirect.com/science...0e66131347c66e

steffi 001 12-18-2006 01:37 PM

Depression hits like a brick
 
For many years I prided myself on avoiding the big "D". Oh...I wasn`t going to go there...Depression wasn`t going to get ME!!!
I was always smiiling,laughing my way through mishaps that are a daily part of a PD`S life.I was reknowned in my local shops as the KID WITH THE BIG GRIN...despite my illness.
"A breath of fresh air"..they used to say..
Well HA BLOODY HA.
One day,out of the blue...this so called "breath of fresh air" was snuffed out and replaced by panic attacks and the heaviest blanket of fog imaginable.

Ask any one of the "veterans" here [not in age but in terms of longevity on this site..well braintalk 1.]
They saw me through the most dismal part of my lfe and HEY...got me through it.
Yes..I had drugs...I begged for them...anything to get me back up there again.And therapy...lots of it.
But you know what...no dependancy,no stigma,no bitter aftertaste.That was about 18 months ago.It lasted but a few months..seemed like years,but what I am driving at here is...if its going to strike it will strike...clinical or emotional.You ain`t ever prepared,you ain`t ready for it.
All I will say is take all the help you can get and KNOW you come through it.
My faith helped a good deal...but still doesn`t shield you from the sense of loss and confusion.
Personally,I don`t think we PD`S are any more prone to anyone else.Life`s a struggle for many...and todays stresses see more and more younger folk getting counselling and they haven`t all got PD have they?
But what do I know.Since then, I don`t take life so seriously.Some PD expert once told me that in twins...it is likely to be the perfectionist who gets PD.Well guess what? Yep I`m a twin,a perfectionist and used to be obsessional.My sister..laid back,takes life with a pich of salt, worries very little.
Could all this have something to do with how we individuallly handle life`s episodes. Just a thought....


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